title: Depressive symptoms and carotid artery intima-media thickness in police officers.
abstract: OBJECTIVE
  Police work is a stressful occupation. Depressive symptoms, which may occur as a result of exposure to stressors in police work, have been known to be associated with an increased risk of cardiovascular disease. This cross-sectional study investigated the association between depressive symptoms and carotid artery intima-media thickness (CIMT) among police officers.
  
  
  METHODS
  CIMT was measured with B-mode carotid ultrasonography. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Analyses of variance and covariance were utilized to examine the mean values of common CIMT (CCA IMT) and maximum CIMT (MMXIMT) across quintiles of depressive symptoms.
  
  
  RESULTS
  Participants included 412 officers (mean age = 41 years). Hypertension status significantly modified the association between CES-D score and CIMT. The association between CES-D score and CCA IMT was statistically significant (adjusted P = 0.030) but only among officers without hypertension. The associations between CES-D score and MMXIMT were not significant among officers with or without hypertension. Our results also showed that among officers who reported poor sleep quality, mean levels of CCA IMT, and MMXIMT tended to increase as depressive symptoms increased.
  
  
  CONCLUSIONS
  Depressive symptoms may be therefore be independently associated with CIMT, yet masked by hypertension. Even though sleep quality did not significantly modify the main association, our results also suggest that poor sleep quality may act synergistically with depressive symptoms to increase CIMT. Future prospective work would help to clarify these associations.
authors.affiliation: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, State University of New York, 270 Farber Hall, Buffalo, NY, 14214, USA, violanti@buffalo.edu.
authors.forename: John M
authors.initials: JM
authors.lastname: Violanti
authors.forename: Luenda E
authors.initials: LE
authors.lastname: Charles
authors.forename: Ja K
authors.initials: JK
authors.lastname: Gu
authors.forename: Cecil M
authors.initials: CM
authors.lastname: Burchfiel
authors.forename: Michael E
authors.initials: ME
authors.lastname: Andrew
authors.forename: P
authors.initials: P
authors.lastname: Nedra Joseph
authors.forename: Joan M
authors.initials: JM
authors.lastname: Dorn
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D035846:Law Enforcement; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012890:Sleep; D013315:Stress, Psychological / Q000453:epidemiology; D055815:Young Adult