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Evaluation of bi-directional causal association between depression and cardiovascular diseases: a Mendelian

Gloria Hoi-Yee Li1,2, Ching-Lung Cheung1, Albert Kar-Kin Chung3

  • 1Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.

Psychological Medicine
|October 9, 2020
PubMed

Insights

Genetic predisposition to depression causally increases the risk for coronary artery disease (CAD) and myocardial infarction (MI). Early depression diagnosis and management are crucial for preventing cardiovascular disease (CVD).

Area of Science:

  • Genetics and Cardiovascular Health
  • Psychiatric Epidemiology
  • Biomedical Research

Background:

  • The intricate relationship between depression and cardiovascular disease (CVD) necessitates further clarification.
  • Existing research indicates an association, but the causal directionality remains uncertain.

Purpose of the Study:

  • To investigate the potential causal links between genetic predisposition to depression and various CVD outcomes, including coronary artery disease (CAD), myocardial infarction (MI), stroke, and atrial fibrillation (AF).
  • To explore whether depression causally influences the risk of developing specific cardiovascular conditions.

Main Methods:

  • Utilized large-scale genome-wide association studies (GWAS) summary statistics for depression (n=500,199) and broad depression (n=322,580).
  • Analyzed GWAS data for CAD (n=184,305), MI (n=171,875), stroke (n=446,696), and AF (n=1,030,836).
  • Employed Mendelian Randomization (MR) analyses to infer causality between genetically predicted depression and CVD outcomes, adjusting for potential mediators like blood lipids and smoking.

Main Results:

  • Significant genetic correlations were found between both depression phenotypes and MI, as well as AF.
  • Genetic liability to depression was causally associated with an increased risk of CAD (OR=1.099) and MI (OR=1.146).
  • The causal association between depression and CAD/MI was partially mediated by blood lipid levels and smoking status; no causal effect of CVD on depression was observed.

Conclusions:

  • Genetic predisposition to depression plays a causal role in the development of CAD and MI.
  • Awareness of mood problems, indicative of depression, is a significant causal risk factor for CAD/MI.
  • Interventions focusing on the prevention and early diagnosis of depression are vital for managing and reducing the risk of CAD/MI.
Abstract

Keywords:
Cardiovascular diseaseMendelian randomizationdepressiongenetics

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