Cardiovascular Disease Risk Factors Among Children and Adolescents With Depression.

Daphne J Korczak,Kristin Cleverley,Farid H Mahmud,Tony Pignatiello,Brian W Mccrindle,Catherine S Birken

doi:10.3389/fpsyt.2021.702737

Abstract

Aim: To examine CVD risk factors among children and adolescents with Major Depressive Disorder (MDD).Methods: A cross-sectional study of 77 children and adolescents (mean age 14.1 years, 74% female) referred to a pediatric depression program. MDD was assessed using a semi-structured diagnostic interview. Cardiovascular assessments included family cardiovascular disease (CVD) history, cigarette smoking, body mass index (BMI), blood pressure, lipid and glucose concentrations. CVD risk factors among healthy weight and overweight/obese participants were compared.Results: Forty-six percent of participants had a family history of early CVD. On examination, 25% of participants had a BMI in overweight/obese range, and 25% of children had pre-hypertension (14%) or hypertension (11%). Total cholesterol levels were elevated among 28% of participants. Overweight/obese participants had increased non-HDL cholesterol concentrations compared with healthy-weight participants (36 vs. 10%, p = 0.01). There were no significant differences between healthy and overweight/obese groups for other CVD risk factors, including HDL cholesterol concentration, plasma glucose concentration, hypertension, cigarette smoking, and family history of early CVD. More than half (52%) of participants had at least two CVD risk factors.Conclusion: CVD risk factors are prevalent among children and adolescents with MDD. Routine CVD risk factor screening may be warranted among MDD youth, regardless of BMI, and may provide a valuable opportunity for prevention of future CVD.

Highlights

Cardiovascular disease (CVD) and Major Depressive Disorder (MDD) are two significant public health problems that are major contributors to the global burden of mortality and morbidity [1,2,3]
Most research to date has been conducted in middleaged and older adults, several prospective epidemiologic studies have reported that the association between MDD and CVD begins decades prior to clinically manifest disease, confirming that youth with MDD are at increased risk of premature atherosclerosis and early CVD-related mortality compared with their non-depressed peers [8]
Increased sedentary behavior and/or decreased physical activity among people with MDD leading to overweight and obesity is one suggested mechanism by which depression may predispose an individual to CVD [9, 10]

Summary

Introduction

Cardiovascular disease (CVD) and Major Depressive Disorder (MDD) are two significant public health problems that are major contributors to the global burden of mortality and morbidity [1,2,3]. Studies have further confirmed that individuals with MDD are at increased risk of poor CVD outcomes even after controlling for their shared comorbidities (e.g., smoking) and other key covariates (e.g., obesity, anti-depressant medication use) [7]. Most research to date has been conducted in middleaged and older adults, several prospective epidemiologic studies have reported that the association between MDD and CVD begins decades prior to clinically manifest disease, confirming that youth with MDD are at increased risk of premature atherosclerosis and early CVD-related mortality compared with their non-depressed peers [8]. Increased sedentary behavior and/or decreased physical activity among people with MDD leading to overweight and obesity is one suggested mechanism by which depression may predispose an individual to CVD [9, 10]

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