TY - JOUR
T1 - Depressive Symptoms and Incident Heart Failure in the Jackson Heart Study
T2 - Differential Risk Among Black Men and Women
AU - Gaffey, Allison E.
AU - Cavanagh, Casey E.
AU - Rosman, Lindsey
AU - Wang, Kaicheng
AU - Deng, Yanhong
AU - Sims, Mario
AU - O’brien, Emily C.
AU - Chamberlain, Alanna M.
AU - Mentz, Robert J.
AU - Glover, Láshauntá M.
AU - Burg, Matthew M.
N1 - Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - BACKGROUND: Associations between depression, incident heart failure (HF), and mortality are well documented in predomi-nately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all-cause mortality across 10 years. METHODS AND RESULTS: We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clini-cally significant depressive symptoms at baseline (Center for Epidemiological Studies– Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF (P=0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All-cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only (P=0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms (P=0.043). CONCLUSIONS: Among Black adults, there were sex-specific associations between depressive symptoms and incident HF, with greater risk among women. Sex-specific management of depression may be needed to improve cardiovascular outcomes.
AB - BACKGROUND: Associations between depression, incident heart failure (HF), and mortality are well documented in predomi-nately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all-cause mortality across 10 years. METHODS AND RESULTS: We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clini-cally significant depressive symptoms at baseline (Center for Epidemiological Studies– Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF (P=0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All-cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only (P=0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms (P=0.043). CONCLUSIONS: Among Black adults, there were sex-specific associations between depressive symptoms and incident HF, with greater risk among women. Sex-specific management of depression may be needed to improve cardiovascular outcomes.
KW - depression
KW - heart failure
KW - lifestyle
KW - race
KW - women
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U2 - 10.1161/JAHA.121.022514
DO - 10.1161/JAHA.121.022514
M3 - Article
C2 - 35191315
AN - SCOPUS:85125554455
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 5
M1 - e022514
ER -