title: Depressive symptoms are associated with incident coronary heart disease or revascularization among blacks but not among whites in the Reasons for Geographical and Racial Differences in Stroke study.
abstract: OBJECTIVE
  To examine the association of depressive symptoms with coronary heart disease (CHD) end points by race and income.
  
  
  METHODS
  Study participants were blacks and whites (n = 24,443) without CHD at baseline from the national Reasons for Geographical and Racial Differences in Stroke cohort. Outcomes included acute CHD and CHD or revascularization. We estimated race-stratified multivariate Cox proportional hazards models of incident CHD and incident CHD or revascularization with the 4-item Center for Epidemiological Studies Depression Scale, adjusting for risk factors.
  
  
  RESULTS
  Mean follow-up was 4.2 ± 1.5 years; CHD incidence was 8.3 events per 1000 person-years (n = 366) among blacks and 8.8 events per 1000 person-years (n = 613) among whites. After adjustment for age, sex, marital status, region, and socioeconomic status, depressive symptoms were significantly associated with incident CHD among blacks (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.00-1.91) but not among whites (HR, 1.10; 95% CI, 0.74-1.64). In the fully adjusted model, compared with blacks who reported no depressive symptoms, those reporting depressive symptoms had greater risk for the composite end point of CHD or revascularization (HR, 1.36; 95% CI, 1.01-1.81). Depressive symptoms were not associated with incident CHD end points among whites.
  
  
  CONCLUSIONS
  High depressive symptoms were associated with higher risk of CHD or revascularization for blacks but not whites.
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS. Electronic address: msims2@umc.edu.
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Nicole
authors.initials: N
authors.lastname: Redmond
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Khodneva
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL; Birmingham Veterans Affairs Medical Center, Birmingham, AL.
authors.forename: Raegan W
authors.initials: RW
authors.lastname: Durant
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Jewell
authors.initials: J
authors.lastname: Halanych
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D003863:Depression / Q000150:complications / Q000208:ethnology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*
keywords: Coronary disease; Depressive symptoms; Epidemiology; Myocardial infarction