title: Relation of Depressive Symptoms With Coronary Artery Calcium Determined by Electron-Beam Computed Tomography (from the Rancho Bernardo Study).
abstract: Studies linking depressive symptoms and coronary artery calcium (CAC), a measure of subclinical atherosclerosis, have yielded mixed results. No longitudinal studies of depressive symptoms and CAC have included older adults of both genders. This study examined the association of depressive symptoms with CAC and CAC progression in older men and women. Participants were 417 community-dwelling older adults (mean age = 67 ± 7) with no history of heart disease who attended a 1997 to 1999 research clinic visit when depressive symptoms were assessed using the Beck Depression Inventory (BDI). CAC was measured using electron-beam computed tomography in 2000 to 2002 and again in 2005 to 2007. Median BDI was 3, range = 0 to 37; 39% of men and 10% of women had severe CAC (Agatston score ≥ 400) in 2000 to 2002. Ordinal logistic regression analyses examining the odds of greater compared with lesser CAC severity by BDI quartiles showed an unexpected negative association whereby women with the lowest depressive symptoms had 2.4 times the odds of increasing CAC severity compared with women in the second BDI quartile (95% CI 1.1 to 5.4). A nonlinear, U-shaped association was observed in men with those in the first and fourth BDI quartiles having 2.6 and 3.0 times higher odds of increasing CAC severity than subjects in the second quartile (95% CI 1.2 to 5.6 and 1.3 to 6.9, respectively) after adjustment for coronary heart disease risk factors. No significant associations were observed for CAC progression although similar nonlinear patterns were observed in men. In conclusion, our results suggest that depressive symptoms have a gender-specific, cross-sectional association with CAC but no statistically significant associations with CAC progression.
authors.affiliation: San Diego State University/University of California San Diego Joint Doctoral Program in Public Health (Epidemiology), University of California, San Diego, San Diego, California; Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California. Electronic address: jbellettiere@ucsd.edu.
authors.forename: John
authors.initials: J
authors.lastname: Bellettiere
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California.
authors.forename: Donna
authors.initials: D
authors.lastname: Kritz-Silverstein
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California.
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.affiliation: Department of Radiology, University of California, San Diego, San Diego, California.
authors.forename: Linda K
authors.initials: LK
authors.lastname: McEvoy
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D002140:California / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*