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Arterial stiffness is associated with depression in middle-aged men - the Maastricht Study
Veronica Onete1, Ronald M Henry1, Simone J S Sep1
1From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler).
Insights
Arterial stiffening is linked to major depressive disorder (MDD) and depressive symptoms in middle-aged men, but not in older adults. This association was also less pronounced in women under 60.
Area of Science:
- Cardiovascular Health
- Mental Health
- Aging Research
Background:
- Arterial stiffening is a potential link between depression and cardiovascular disease (CVD).
- Existing data on the association between arterial stiffness and depression are inconsistent.
- The role of sex and age in this relationship requires further investigation.
Purpose of the Study:
- To investigate the association between aortic stiffness and major depressive disorder (MDD).
- To examine the link between aortic stiffness and depressive symptoms.
- To determine if these associations differ by sex and age.
Main Methods:
- Carotid-femoral pulse wave velocity (cfPWV) was measured using applanation tonometry.
- Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI) and Patient Health Questionnaire-9 (PHQ-9).
- Logistic and negative binomial models were adjusted for age, type 2 diabetes mellitus (T2DM), mean arterial pressure (MAP), and CVD risk factors.
Main Results:
- Aortic stiffness (cfPWV) was associated with MDD in men aged 60 or younger (OR 2.36).
- This association was not significant in women of the same age group (OR 1.57) or in any participants over 60.
- cfPWV was linked to higher PHQ-9 scores in men aged 60 or younger (RR 1.28), but not in women or older individuals.
Conclusions:
- Greater aortic stiffness is associated with MDD and depressive symptoms in middle-aged men.
- The association between aortic stiffness and depression is less evident in women and absent in older adults.
- Reversed causation cannot be excluded due to the cross-sectional study design.
Background:
Arterial stiffening may underlie the association between depression and cardiovascular disease (CVD), but reported data are inconsistent. We investigated the associations between aortic stiffness and major depressive disorder (MDD) and depressive symptoms, and whether these differed by sex and age.
Methods:
We measured carotid to femoral pulse wave velocity (cfPWV) using applanation tonometry, and we assessed depression using the Mini-International Neuropsychiatric Interview (MINI) and the Patient Health Questionnaire-9 (PHQ-9) in a cohort of participants from The Maastricht Study. Logistic and negative binominal models were adjusted for age, type 2 diabetes mellitus (T2DM), mean arterial pressure (MAP) and CVD risk factors.
Results:
We included 2757 participants in our analyses (48.8% men, mean age 59.8 ± 8.1 yr, 27% T2DM). We found that cfPWV was associated with MDD in men (fully adjusted odds ratio [OR] 2.36, 95% confidence interval [CI] 1.45-3.84), but not in women (OR 1.57, 95% CI 0.93-2.66), aged 60 years or younger. The ORs were not significant in individuals older than 60 years (men: OR 1.03, 95% CI 0.63-1.68; women: OR 0.64, 95% CI 0.32-1.31). Similarly, cfPWV was associated with a higher PHQ-9 score in men (rate ratio 1.28, 95% CI 1.09-1.52), but not in women (rate ratio 1.11, 95% CI 0.99-1.23), aged 60 years or younger. Associations were not significant in individuals older than 60 years (men: rate ratio 0.96, 95% CI 0.84-1.08; women: rate ratio 1.00, 95% CI 0.90-1.12).
Limitations:
We cannot rule out reversed causation in this cross-sectional study.
Conclusion:
Greater aortic stiffness is associated with MDD and depressive symptoms among middle-aged men and to a lesser extent in women, whereas this association was not observed in old age.
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