title: Associations of Depressive Symptoms and Brachial Artery Reactivity among Police Officers.
abstract: OBJECTIVE
  Mental health has been shown to be linked with certain underlying physiological mechanisms. The objective of this cross sectional study was to investigate the relationship between depressive symptoms and brachial artery reactivity (BAR) in an understudied population: police officers.
  
  
  METHODS
  Participants were 351 police officers who were clinically examined in the Buffalo Cardio-Metabolic Police Stress (BCOPS) study. BAR was performed using standard B-Mode ultrasound procedures. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Mean values of the difference between the baseline and maximum diameters of the brachial artery were determined across three categories of CES-D score using the analysis of variance and the analysis of covariance. p-values for linear trends were obtained from linear regression models.
  
  
  RESULTS
  The mean age (± standard deviation) of all officers was 40.9 ± 7.2 years. Women had a slightly higher mean CES-D score than men (8.9 ± 8.9 vs. 7.4 ± 6.4) and a slightly higher percentage increase of BAR than men (6.90 vs. 5.26%). Smoking status significantly modified the associations between depressive symptoms and BAR. Among current smokers, mean absolute values of BAR significantly decreased as depressive symptoms increased after adjustment for age, gender, race/ethnicity, hypertension, and diabetes; the multivariate-adjusted p-values were 0.033 (absolute) and 0.040 (%). Associations between depressive symptoms and BAR were not statistically significant among former smokers or never smokers.
  
  
  CONCLUSIONS
  Depressive symptoms were inversely associated with BAR among police officers who were current smokers and together may be considered a risk factor for cardiovascular disease among police officers. Further prospective research is warranted.
authors.affiliation: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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: Parveen N
authors.initials: PN
authors.lastname: Joseph
authors.forename: Joan M
authors.initials: JM
authors.lastname: Dorn
keywords: Cardiovascular diseases; Depression; Occupational health; Police; Smoking