Individuals with depression, especially men, may be at increased risk for all-cause and CVD mortality, according to results of a prospective cohort study conducted in China and published in JAMA Network Open.
“Although there have been more than 250 cohort studies conducted in other populations, very few of these were in Chinese populations, and almost none in mainland China," An Pan, PhD, of the School of Public Health at Huazhong University of Science and Technology in China, told Healio Psychiatry. "Clinicians should be aware of this association and pay attention to the cardiovascular risk factors for patients with depression. If the patient is at higher risk for cardiovascular disease or mortality, then preventive or treatment measures are needed to lower this risk."
The researchers noted that most of this prior research was performed in Western countries, and high-quality studies in Chinese populations are likely lacking. To address this research gap, they followed adults aged 30 to 79 years who were included in the China Kadoorie Bank (CKB) study, as well as adults aged 32 to 104 years who were included in the Dongfeng-Tongji (DFTJ) study. Using a Chinese version of the WHO International Diagnostic Interview-Short Form in the CKB cohort and a seven-item symptoms questionnaire modified from the same interview format for the DFTJ study, they evaluated participant depression.
The researchers analyzed data from 512,712 in the CKB cohort and found 44,065 deaths, of which 18,273 were CVD deaths. Among this cohort, the 12-month prevalence of major depressive episode was 0.64%. The 1-month prevalence of clinically significant depressive symptoms in the DFJT cohort was 17.96%. They analyzed data from 26,298 individuals in the DFTJ cohort and found 2,571 deaths, of which 1,012 were CVD deaths. A multivariable-adjusted model revealed that depression was associated with increased risk for all-cause mortality, with a hazard ratio of 1.32 (95% CI, 1.2-1.46) in the CKB cohort and
1.17 in the DFJT cohort (95% CI, 1.06-1.29). They also reported an increased risk for CVD mortality associated with depression, with a hazard ratio of 1.22 (95% CI, 1.04-1.44) for the CKB cohort and 1.32 (95% CI, 1.15-1.54) for the DFJT cohort. Men had statistically significantly higher risk for all-cause mortality and CVD mortality in both cohorts. However, the association of depression with mortality among women was only significant for all-cause mortality in the CKB cohort.
“Given the high disease burdens associated with depression and CVD in the general population and the low treatment rate in Chinese population, our findings have significant clinical and public health importance, and more efforts are needed in China to increase awareness and improve treatment strategies for individuals with depression,” Pan and colleagues wrote. – by Joe Gramigna
Disclosures: The authors report no relevant financial disclosures.