Metabolic syndrome, major depression, generalized anxiety disorder, and ten-year all-cause and cardiovascular mortality in middle aged and elderly patients.
BACKGROUND
Studies investigating specifically whether metabolic syndrome (MetS) and common psychiatric disorders are independently associated with mortality are lacking. In a middle-aged general population, we investigated the association of the MetS, current major depressive episode (MDE), lifetime MDE, and generalized anxiety disorder (GAD) with ten-year all-cause and cardiovascular disease mortality.


METHODS
From February 2003 until January 2004, 1115 individuals aged 45 years and older were randomly selected from a primary care practice and prospectively evaluated for: (1) MetS (The World Health Organization [WHO], National Cholesterol Education Program/Adult Treatment Panel III and International Diabetes Federation [IDF] definitions); (2) current MDE and GAD, and lifetime MDE (Mini International Neuropsychiatric Interview); and (3) conventional cardiovascular risk factors. Follow-up continued through January, 2013.


RESULTS
During the 9.32 ± 0.47 years of follow-up, there were 248 deaths, of which 148 deaths were attributed to cardiovascular causes. In women, WHO-MetS and IDF-MetS were associated with greater all-cause (HR-values range from 1.77 to 1.91; p-values ≤ 0.012) and cardiovascular (HR-values range from 1.83 to 2.77; p-values ≤ 0.013) mortality independent of cardiovascular risk factors and MDE/GAD. Current GAD predicted greater cardiovascular mortality (HR-values range from 1.86 to 1.99; p-values ≤ 0.025) independently from MetS and cardiovascular risk factors. In men, the MetS and MDE/GAD were not associated with mortality.


CONCLUSIONS
In middle aged women, the MetS and GAD predicted greater 10-year cardiovascular mortality independently from each other; 10-year all-cause mortality was independently predicted by the MetS. MetS and GAD should be considered important and independent mortality risk factors in women.
Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Jurate
J
Butnoriene
Institute of Neurosciences, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: a.bunevicius@yahoo.com.
Adomas
A
Bunevicius
Department of Informatics, Vytautas Magnus University, Kaunas, Lithuania.
Ausra
A
Saudargiene
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
Charles B
CB
Nemeroff
Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Antanas
A
Norkus
Institute of Hygiene, Vilnius, Lithuania.
Vile
V
Ciceniene
Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
Robertas
R
Bunevicius
D000367:Age Factors; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
Anxiety; Cardiovascular mortality; Depression; Metabolic syndrome