Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study.
Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design A population-based, health and nutrition prospective survey. Methods In the context of the ATTICA Study (2002-2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results After adjustment for multiple established CVD risk factors, both reported depression and anxiety levels were positively and independently associated with the 10-year CVD incidence, with depression markedly increasing the CVD risk by approximately fourfold (adjusted odds ratio (95% confidence interval) 3.6 (1.3, 11) for depression status; 1.03 (1.0, 1.1) for anxiety levels). Conclusions Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.|2 Aston Medical Research Institute, Aston University, UK.|3 Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK.|4 WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK.
Ioannis
I
Kyrou
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.
Natasa
N
Kollia
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.
Demosthenes
D
Panagiotakos
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.
Ekavi
E
Georgousopoulou
5 First Cardiology Clinic, University of Athens, Greece.
Christina
C
Chrysohoou
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.
Constantine
C
Tsigos
2 Aston Medical Research Institute, Aston University, UK.|3 Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK.|4 WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK.
Harpal S
HS
Randeva
1 Department of Science of Dietetics and Nutrition, Harokopio University, Greece.
Mary
M
Yannakoulia
5 First Cardiology Clinic, University of Athens, Greece.
Christodoulos
C
Stefanadis
6 Department of Psychiatry School of Medicine, University of Athens, Greece.
Charalabos
C
Papageorgiou
5 First Cardiology Clinic, University of Athens, Greece.
Christos
C
Pitsavos
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016009:Chi-Square Distribution; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D013997:Time Factors
ATTICA Study; CVD risk factors; anxiety; cardiovascular disease; depression