title: Psychological distress and risk of peripheral vascular disease, abdominal aortic aneurysm, and heart failure: pooling of sixteen cohort studies.
abstract: OBJECTIVE
  Examine the little-tested relation of psychological distress with peripheral vascular disease, abdominal aortic aneurysm, and heart failure.
  
  
  METHODS
  Pooling of raw data from 166,631 male and female participants in 16 UK-based cohort studies. Psychological distress was measured using the 12-item General Health Questionnaire. Peripheral vascular disease, abdominal aortic aneurysm, and heart failure events were based on death register linkage.
  
  
  RESULTS
  During a mean follow-up 9.5 years there were 17,368 deaths of which 8625 were cardiovascular disease-related. Relative to the asymptomatic group (0 score), the highly distressed group (score 7-12) experienced an elevated risk of peripheral vascular disease (adjusted hazard ratio; 95% confidence interval: 3.39; 1.97, 5.82) and heart failure (1.76; 1.37, 2.26). Psychological distress was weakly related to the risk of death from abdominal aortic aneurysm. As anticipated, distress was associated with cardiovascular disease, coronary heart disease, and all strokes combined.
  
  
  CONCLUSIONS
  In the present study, we provide new evidence of mental health-related cardiovascular disease presentations.
authors.affiliation: Department of Epidemiology and Public Health, University College, London, UK; Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, UK. Electronic address: david.batty@ucl.ac.uk.
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.affiliation: Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, UK; Division of Psychiatry, University of Edinburgh, UK; Scottish Dementia Clinical Research Network, NHS Scotland, UK.
authors.forename: Tom C
authors.initials: TC
authors.lastname: Russ
authors.affiliation: Department of Epidemiology and Public Health, University College, London, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Stamatakis
authors.affiliation: Department of Epidemiology and Public Health, University College, London, UK.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000401:mortality / Q000523:psychology; D002423:Cause of Death; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality / Q000523:psychology; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000523:psychology; D012042:Registries; D012306:Risk; D013315:Stress, Psychological / Q000453:epidemiology*; D020521:Stroke / Q000401:mortality / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Abdominal aortic aneurysm; Cardiovascular disease; Epidemiology; Heart failure; Mental health; Peripheral vascular disease; Psychological distress