Abstract

Background: Poorer mental health is associated with greater cardiovascular disease (CVD) morbidity, recovery, and mortality. Experiencing CVD is also associated with poorer mental health after a CVD event. What has been less examined, is how these associations differ among disaggregated Asian and Pacific Islander (API) groups who have a lower burden of both CVD and poor mental health relative to other racial groups. Objective: To examine the association between CVD diagnosis and experiencing major depressive disorder (MDD) among API people and how it differs between racial groups. Methods: We used survey data (n=5,229) from a study of API patients in Hawai’i and California with a linked electronic health record (EHR) data. Race, sex, body mass index (BMI) and CHD, Stroke, and PVD diagnosis were obtained from EHR while MI and CAD diagnoses were from the survey. Data on health behaviors and social determinants were obtained from the survey. Multivariate logistic regression models were used to determine the association between CVD and MDD. Results: Overall prevalence of MDD was 9.2%. Non-Hispanic White people (6.1%) had the lowest prevalence while “Pacific Islander and White” people had the highest prevalence (12.8%). In the fully adjusted models (Table), people who had a stroke (OR = 1.34, p < .001), CHD (OR = 1.32, p = .01), CAD (OR = 1.35, p = .016) or PVD (OR = 1.49, p < .001) had increased odds of MDD. There was a significant interaction between CAD and increased MDD that differed for Filipino, Asian Indian, “Pacific Islander and Asian”, “Asian and White”, and “Pacific Islander and White” groups compared to Non-Hispanic White people. Conclusion: Diagnosis of certain CVDs could increase the risk of experiencing MDD with potential race group differences for CAD. Further efforts should be made to protect the mental health of patients that have experienced a diagnosis of CVD as MDD can further harm their health outcomes. Moreover, research and treatment should consider potential racial differences in the experience of depression and CVD.

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