Related Experiment Videos

Effect of collaborative care for depression on risk of cardiovascular events: data from the IMPACT randomized

Jesse C Stewart1, Anthony J Perkins, Christopher M Callahan

  • 1Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St, LD 100E, Indianapolis, IN 46202. jstew@iupui.edu.

Psychosomatic Medicine
|December 25, 2013
PubMed

Insights

Treating depression before cardiovascular disease (CVD) onset significantly reduced CVD events in older adults. This collaborative care approach shows promise as a primary prevention strategy for heart health.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Depression is a known risk factor for cardiovascular disease (CVD).
  • Previous depression treatment trials in cardiac patients have not yielded expected cardiovascular benefits.
  • The Indiana sites of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial were used for this 8-year follow-up study.

Purpose of the Study:

  • To test the hypothesis that depression treatment administered before clinical CVD onset can decrease the risk of subsequent CVD events.
  • To evaluate the long-term impact of a collaborative care model for depression on cardiovascular outcomes.

Main Methods:

  • A randomized controlled trial involving 235 primary care patients aged 60+ with major depression or dysthymia.
  • Participants received either a 12-month collaborative care program (antidepressants and psychotherapy) or usual care.
  • Hard CVD events were tracked using electronic medical records and Medicare/Medicaid data over 8 years.

Main Results:

  • A significant treatment × baseline CVD interaction was observed (p = .021).
  • IMPACT patients without baseline CVD had a 48% lower risk of CVD events compared to usual care (28% vs. 47%).
  • No significant difference in CVD events was found between IMPACT and usual care patients with pre-existing CVD (86% vs. 81%).

Conclusions:

  • Collaborative depression care initiated before CVD onset effectively halved the risk of hard CVD events in older, depressed individuals.
  • The IMPACT intervention may serve as a viable primary prevention strategy for cardiovascular disease.
Abstract

Keywords:
cerebrovascular disorderscoronary diseasedepressionfollow-up studiesprevention

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