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Elevated depressive affect is associated with adverse cardiovascular outcomes among African Americans with chronic

Michael J Fischer1, Paul L Kimmel, Tom Greene

  • 1Department of Medicine and Biostatistics and Epidemiology, Jesse Brown VA Medical Center and University of Illinois Medical Center, 5000 S. 5th Avenue, Hines, IL 60141, USA. fischerm@uic.edu

Kidney International
|June 3, 2011
PubMed

Insights

Elevated depressive affect is linked to worse cardiovascular outcomes in African Americans with hypertensive chronic kidney disease. Higher Beck Depression Inventory II scores indicate increased risk for cardiovascular events.

Area of Science:

  • Nephrology
  • Cardiology
  • Psychiatry

Background:

  • Hypertensive chronic kidney disease (CKD) disproportionately affects African Americans.
  • Depression is a common comorbidity in patients with chronic diseases.
  • The impact of depressive affect on cardiovascular outcomes in this specific population requires further investigation.

Purpose of the Study:

  • To examine the association between elevated depressive affect and adverse health outcomes in the African-American Study of Kidney Disease and Hypertension (AASK) Cohort.
  • To determine if depressive affect predicts cardiovascular death/hospitalization, kidney disease progression, or overall mortality.

Main Methods:

  • Utilized data from the AASK Cohort Study, including 628 participants.
  • Assessed depressive affect using the Beck Depression Inventory II (BDI-II) with various thresholds (≥11, >14).
  • Employed Cox regression analyses to evaluate baseline, time-varying, and cumulative depressive affect in relation to health outcomes over a 5-year follow-up.

Main Results:

  • 42% of participants had BDI-II scores ≥11, and 26% had scores >14 at baseline.
  • Elevated depressive affect (BDI-II ≥11) at baseline was associated with greater cumulative incidence of cardiovascular death/hospitalization.
  • Time-varying elevated depressive affect (BDI-II >14) showed a significant adjusted hazard ratio of 1.63 for cardiovascular death/hospitalization.

Conclusions:

  • Elevated depressive affect is significantly associated with adverse cardiovascular outcomes in African Americans with hypertensive CKD.
  • Depressive affect, particularly when assessed over time, is a predictor of cardiovascular events in this population.
  • These findings highlight the importance of screening and managing depressive affect in hypertensive CKD patients of African American descent.

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