title: The relationship between depression, anxiety and cardiovascular disease: findings from the Hertfordshire Cohort Study.
abstract: BACKGROUND
  Previous studies suggest a link between depression, anxiety and cardiovascular disease (CVD). The aim of the study was to determine the relationship between depressive and anxiety symptoms and CVD in a population based cohort.
  
  
  METHODS
  In total 1578 men and 1,417 women from the Hertfordshire Cohort Study were assessed for CVD at baseline and after 5.9 ± 1.4 years. Depressive and anxiety symptoms were measured using the HADS scale.
  
  
  RESULTS
  Baseline HAD-D score, but not HAD-A, was significantly associated with baseline plasma triglycerides, glucose and insulin resistance (men only) and HDL cholesterol (women only). After adjustment for CVD risk factors, higher baseline HAD-D scores were associated with increased odds ratios for CVD (men: 1.162 [95% CI 1.096-1.231]; women: 1.107 [1.038-1.181]). Higher HAD-A scores associated with increased CVD in men only. High HAD-D scores predicted incident CVD (adjusted OR 1.130 [1.034-1.235]), all-cause mortality (adjusted HR 1.081, [1.012-1.154]) and cardiovascular mortality (adjusted HR 1.109 [1.002-1.229]) in men but not in women.
  
  
  CONCLUSIONS
  The use of a self-report measure of depressive and anxiety symptoms, 'healthy' responder bias and the low number of cardiovascular events are all limitations.
  
  
  CONCLUSIONS
  Depressive and anxiety symptoms are commoner in people with CVD. These symptoms are independent predictors of CVD in men. Although HAD-D score was significantly associated with several cardiovascular risk factors, this did not fully explain the association between HAD-D and CVD.
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK. R.I.G.Holt@soton.ac.uk
authors.forename: Richard I G
authors.initials: RI
authors.lastname: Holt
authors.forename: David I W
authors.initials: DI
authors.lastname: Phillips
authors.forename: Karen A
authors.initials: KA
authors.lastname: Jameson
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Dennison
authors.forename: Robert C
authors.initials: RC
authors.lastname: Peveler
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000523:psychology*; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D014280:Triglycerides / Q000097:blood; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Anxiety; Cardiovascular disease; Depression; Epidemiology; Population studies