title: Depression, anxiety and 6-year risk of cardiovascular disease.
abstract: OBJECTIVE
  Depression and anxiety are considered etiological factors in cardiovascular disease (CVD), though their relative contribution and differentiation by clinical characteristics have not been studied intensively. We examined 6-year associations between depressive and anxiety disorders, clinical characteristics and newly-developed CVD.
  
  
  METHODS
  DSM-IV diagnoses were established in 2510 CVD-free participants of the Netherlands Study of Depression and Anxiety. Data on subtype, severity, and psychoactive medication were collected. The 6-year incidence of CVD was assessed using Cox regression analyses adjusted for sociodemographic, health and lifestyle factors.
  
  
  RESULTS
  One-hundred-six subjects (4.2%) developed CVD. Having both current depressive and anxiety disorders (HR=2.86, 95%CI 1.49-5.49) or current depression only (HR=2.30; 95%CI 1.10-4.80) was significantly associated with increased CVD incidence, whereas current anxiety only (HR=1.48; 95%CI 0.74-2.96) and remitted disorders (HR=1.48; 95%CI 0.80-2.75) were not associated. Symptom severity was associated with increased CVD onset (e.g., Inventory of Depressive Symptomatology per SD increase: HR=1.51; 95%CI 1.25-1.83). Benzodiazepine use was associated with additional CVD risk (HR=1.95; 95%CI 1.16-3.31).
  
  
  CONCLUSIONS
  Current depressive (but not anxiety) disorder independently contributed to CVD in our sample of initially CVD-free participants. CVD incidence over 6years of follow-up was particularly increased in subjects with more symptoms, and in those using benzodiazepines.
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: a.seldenrijk@ggzingeest.nl.
authors.forename: Adrie
authors.initials: A
authors.lastname: Seldenrijk
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Vogelzangs
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Neeltje M
authors.initials: NM
authors.lastname: Batelaan
authors.affiliation: Department of Health Sciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Iris
authors.initials: I
authors.lastname: Wieman
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Digna J F
authors.initials: DJ
authors.lastname: van Schaik
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Brenda J W H
authors.initials: BJ
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000523:psychology*; D003863:Depression / Q000150:complications; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D010555:Personality Inventory; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D001569:Benzodiazepines
keywords: Anxiety disorders; Cardiovascular diseases; Depressive disorders