Abstract P214: Anxiety and Depressive Symptoms are Associated with Coronary Artery Calcium. A Cross-sectional Analysis of Elsa-Brasil Baseline Data

Abstract

Background: Prior mostly smaller studies of the association between symptoms of anxiety or depression and CAC have produced mixed results. Our aim was to investigate whether psychopathological symptoms and diagnoses of anxiety and depression were associated with coronary artery calcium (CAC) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Design: Cross-sectional analysis Methods: We analyzed data from 4,279 ELSA-Brasil subjects (aged 35 to 74 years) from the São Paulo site who underwent CAC score assessment and who were without previous cardiovascular disease at baseline. Prevalent CAC was defined as a CAC score above zero. Anxiety and depressive symptoms were assessed using the Clinical Interview Schedule - Revised (CIS-R). We built binary logistic regression models to determine whether CIS-R scores, anxiety or depression were associated with prevalent CAC. Results: Prevalent CAC was found in 1,211 (28.3%) individuals. After adjustment for age and sex, a direct association between CIS-R scores and prevalent CAC was revealed (odds ratio [OR]:1.12; 95% confidence interval [95%CI]:1.04-1.22). This association persisted after multivariate adjustment for other cardiovascular risk factors (OR:1.11; 95%CI: 1.02-1.20). No independent associations were found for specific diagnoses of anxiety or depression and prevalent CAC. In post-hoc models, we found a significant interaction between age, CIS-R scores, and CAC (p=0.019), suggesting a stronger association in older individuals. Conclusions: Psychopathological symptoms were directly associated with coronary atherosclerosis in the ELSA-Brasil baseline. This association was evident after adjustment for age and sex, persisted in multivariate adjusted models, and seems to be stronger in older individuals.