Abstract 14193: Depression Worsens Cardiovascular Health: A Population-based Cohort Study (NHANES, 2015-16)

Abstract

Introduction: Depression increases cardiovascular risk, but associations between depression and cardiovascular risk profiles have had limited investigation. We hypothesized that depression is associated with cardiovascular risk factors in a population-based cohort. Methods: We selected participants from the 2015-16 National Health and Nutrition Examination Survey (NHANES) and age ≥25 years. Participants completed the Patient Health Questionnaire (PHQ), a 9-item, validated instrument categorizing minimal (0-4), mild (5-9) or moderate-to-severe (≥10) depression. We employed the American Heart Association’s assessment of cardiovascular health, Life’s Simple 7 (LS7) which uses risk factors (smoking status, BMI, physical activity, diet, cholesterol, blood pressure, and glycohemoglobin) to categorize cardiovascular health as poor (0-1), intermediate (5-9) or ideal (10-14). We related PHQ scores to cardiovascular health as measured by LS7 in regression analyses adjusted for relevant covariates (age, sex, race, education, health insurance and poverty-income level). Results: Among 5053 NHANES participants, 4003 (79%) had data for the PHQ and determination of LS7 scores (age 51±16; 52% female; 67% white race). Individuals with mild depression (PHQ 5-9) had 1.4-times greater likelihood (95% CI, 1.07-1.92) of lower cardiovascular health compared to those without depression in multivariable-adjusted models. Likewise, individuals with moderate depression (PHQ≥10) had 3-times greater likelihood (95% CI, 1.90-4.97) of lower cardiovascular health compared to those without depression. Conclusions: In a socially diverse cohort, individuals with depression were more likely to have significantly lower cardiovascular health compared to those without depression. Our findings show that depression may be a barrier to cardiovascular health promotion. Addressing depression appears essential to improve cardiovascular health.