Abstract

Introduction: Depression is a non-traditional risk factor for cardiovascular disease (CVD). Data on the association of depression and poor mental health with CVD and suboptimal cardiovascular health (CVH) among young adults are limited. Methods: We utilized data from 593,616 young adults (18-44 years) from the 2017-2020 Behavioral Risk Factor Surveillance System, a nationally representative survey of non-institutionalized US adults. Exposures were self-reported depression and poor mental health days (PMHD, categorized as 0 days, 1-13 days, 14-30 days poor mental health in the past 30 days), and outcomes were self-reported CVD (MI, angina, or stroke) and suboptimal CVH (≥ 2 risk factors: hypertension, hypercholesterolemia, overweight/obesity, current smoker, diabetes, inactivity, and inadequate fruit and vegetable intake). Using logistic regression, we investigated the association of depression and PMHD with CVD and suboptimal CVH adjusted for sociodemographic factors (and CVD risk factors for CVD). Results: The weighted prevalence of CVD was 2.5% (95% CI 2.4%-2.6%), and depression was 19.6% (95% CI 19.4%-19.8%). CVD was more common among young adults with depression than those without (fully adjusted odds ratio [aOR]: 2.28, 95% CI: 2.10-2.48, Fig. 1A). There was a graded association of PMHD with CVD. Compared with individuals with 0 PMHD, the odds of CVD in those with 1-13 PMHD and 14-30 PHMD were 1.49 (95% CI:1.36-1.64) and 2.26 (95% CI: 2.06-2.48)(Fig. 1B), respectively after adjusting for sociodemographic and CV risk factors. Individuals with depression had higher odds of suboptimal CVH (aOR: 1.77, 95% CI: 1.67-1.88)(Fig 1C) compared with those without depression, with a similar graded relationship observed between PMHD and CVH ( Fig 1D). Conclusion: Depression and poor mental health are associated with premature CVD and suboptimal CVH in young US adults. Prioritizing mental health may help reduce CVD risk and improve CVH in young adults.

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