Cardiovascular disease in persons with depressive and anxiety disorders.
BACKGROUND
Associations between depression, and possibly anxiety, with cardiovascular disease have been established in the general population and among heart patients. This study examined whether cardiovascular disease was more prevalent among a large cohort of depressed and/or anxious persons. In addition, the role of specific clinical characteristics of depressive and anxiety disorders in the association with cardiovascular disease was explored.


METHODS
Baseline data from the Netherlands Study of Depression and Anxiety were used, including persons with a current (i.e. past year) or remitted DSM-IV depressive or anxiety disorder (N=2315) and healthy controls (N=492). Additional clinical characteristics (subtype, duration, severity, and psychoactive medication) were assessed. Cardiovascular disease (stroke and coronary heart disease) was assessed using algorithms based on self-report and medication use.


RESULTS
Persons with current anxiety disorders showed an about three-fold increased prevalence of coronary heart disease (OR anxiety only=2.70, 95%CI=1.31-5.56; OR comorbid anxiety/depression=3.54, 95%CI=1.79-6.98). No associations were found for persons with depressive disorders only or remitted disorders, nor for stroke. Severity of depressive and anxiety symptoms--but no other clinical characteristics--most strongly indicated increased prevalence of coronary heart disease.


CONCLUSIONS
Cross-sectional design.


CONCLUSIONS
Within this large psychopathology-based cohort study, prevalence of coronary heart disease was especially increased among persons with anxiety disorders. Increased prevalence of coronary heart disease among depressed persons was largely owing to comorbid anxiety. Anxiety-alone as well as comorbid to depressive disorders-as risk indicator of coronary heart disease deserves more attention in both research and clinical practice.
Vogelzangs
Nicole
N
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands. n.vogelzangs@vumc.nl
Seldenrijk
Adrie
A
Beekman
Aartjan T F
AT
van Hout
Hein P J
HP
de Jonge
Peter
P
Penninx
Brenda W J H
BW
D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D009426:Netherlands; D012016:Reference Values; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy