Interactive effects of race and depressive symptoms on calcification in African American and white women.
OBJECTIVE
To examine the cross-sectional associations among race, depressive symptoms, and aortic and coronary calcification in a sample of middle-aged women. Depressive symptoms have been associated with atherosclerotic indicators of coronary heart disease (CHD) in white women. Few studies have examined these associations in samples including African American women, or explored whether any observed associations differ by race.


METHODS
Participants were 508 (38% African American, 62% white) women. Aortic and coronary calcification were measured by electron beam tomography and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariable linear and logistic regression models were conducted to test associations.


RESULTS
In linear regression models adjusted for race, depressive symptoms were associated with a greater amount of aortic calcification (beta = 0.03, p = .01), and there was a significant race x depressive symptoms interaction (beta = 0.07, p = .006). Findings for depressive symptoms (odds ratio (OR) = 1.03, 95% Confidence Interval (CI) = 1.0-1.06, p = .07), and the race x depressive symptoms interaction (OR = 1.1, 95% CI = 1.01-1.18, p = .01) were similar in race-adjusted multinomial logistic regression models predicting high levels of aortic calcification. Race-specific models revealed a significant association between depressive symptoms and aortic calcification in African American, but not white women. Additional adjustments for education, study site, and CHD risk factors did not alter these results. Depressive symptoms were not associated with coronary calcification for women of either racial group.


CONCLUSIONS
African American women may be particularly vulnerable to the effects of depressive symptoms on early atherosclerotic disease.
Lewis
Tené T
TT
Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06510, USA. tene.lewis@yale.edu
Everson-Rose
Susan A
SA
Colvin
Alicia
A
Matthews
Karen
K
Bromberger
Joyce T
JT
Sutton-Tyrrell
Kim
K
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000523:psychology; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000523:psychology; D015992:Body Mass Index; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000523:psychology; D002641:Chicago / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology*; D003866:Depressive Disorder / Q000208:ethnology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000208:ethnology; D014057:Tomography, X-Ray Computed; D044465:White People / Q000706:statistics & numerical data*
D008055:Lipids