title: Depressive symptoms and self-reported adherence to medical recommendations to prevent cardiovascular disease: NHANES 2005-2010.
abstract: This study's aim was to examine the relationships between depressive symptom severity and adherence to medication and lifestyle recommendations intended to prevent cardiovascular disease (CVD) in a large, diverse sample of men and women representative of the U.S.
  
  
  METHODS
  Participants were adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 with a self-reported history of hypertension and/or hypercholesterolemia, but no CVD. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms, and the Blood Pressure and Cholesterol interview was used to assess self-reported adherence to five medical recommendations: take antihypertensive medication (n = 3313), eat fewer high fat/cholesterol foods (n = 2924), control/lose weight (n = 2177), increase physical activity (n = 2540), and take cholesterol medication (n = 2266). Logistic regression models (adjusted for demographics, diabetes, body mass index, smoking, and alcohol intake) revealed that a 1-SD increase in PHQ-9 score was associated with a 14% lower odds of adherence to the control/lose weight recommendation (OR = 0.86, 95% CI: 0.75-0.98, p = .02) and a 25% lower odds of adherence to the increase physical activity recommendation (OR = 0.75, 95% CI: 0.65-0.86, p < .001). PHQ-9 score, however, was not related to the odds of adherence to the take antihypertensive medication (p = .21), eat fewer high fat/cholesterol foods (p = .40), or take cholesterol medication (p = .90) recommendations. Our findings suggest that poor adherence to provider recommendations to control/lose weight and to increase physical activity may partially explain the excess risk of CVD among depressed persons.
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Berntson
authors.affiliation: OurHealth, Indianapolis, IN, USA.
authors.forename: Kendra Ray
authors.initials: KR
authors.lastname: Stewart
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Vrany
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Khambaty
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA. Electronic address: jstew@iupui.edu.
authors.forename: Jesse C
authors.initials: JC
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003863:Depression / Q000145:classification; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009749:Nutrition Surveys; D010349:Patient Compliance / Q000523:psychology*; D057566:Self Report; D012720:Severity of Illness Index; D014481:United States
keywords: Adherence; Cardiovascular disease; Depressive symptoms; NHANES