Combined influence of depressive symptoms and systemic inflammation on cardiovascular diseases in China
Xiaowei Zheng1, Minglan Jiang1, Xiao Ren1
1Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
Insights
Depressive symptoms and inflammation significantly increase cardiovascular disease (CVD) risk. Their combined effect is multiplicative, highlighting the need for integrated screening strategies for CVD prevention.
Area of Science:
- Cardiovascular Disease Epidemiology
- Psychosomatic Medicine
- Biomarkers of Inflammation
Background:
- Previous research established a link between depressive symptoms and inflammation.
- The combined impact of these factors on cardiovascular disease (CVD) risk requires further investigation.
Purpose of the Study:
- To assess the synergistic effect of depressive symptoms and inflammation levels on the incidence of CVD.
- To analyze the combined risk of developing CVD, stroke, and cardiac events.
Main Methods:
- Utilized data from 9647 participants in the China Health and Retirement Longitudinal Study.
- Employed multivariate Cox proportional hazards regression to analyze associations.
- Examined depressive symptoms, high-sensitivity C-reactive protein (hsCRP) levels, and CVD outcomes.
Main Results:
- 1731 participants developed CVD (560 stroke, 1306 cardiac events) during follow-up.
- Individuals with both depressive symptoms and high hsCRP showed a 1.61-fold increased risk of CVD compared to those with neither.
- Demonstrated additive and multiplicative interactions between depressive symptoms and inflammation on CVD risk.
Conclusions:
- A significant multiplicative effect exists between depressive symptoms and inflammation on CVD risk.
- The combination of depressive symptoms and inflammation may serve as a valuable screening tool for identifying high-risk individuals.
- Further large-scale prospective studies are recommended to validate these findings and their clinical application.
Objective:
Previous studies had reported a significant association between depressive symptoms and inflammation. The aim of present study was to evaluate the combined effect of depressive symptoms and inflammation level on the risk of cardiovascular disease (CVD).
Methods:
A total of 9647 participants from the China Health and Retirement Longitudinal Study were included. Multivariate Cox proportional hazards regression model was used to evaluate the associations between depressive symptoms, inflammation level and new-onset CVD, stroke and cardiac events.
Results:
There were 1731 respondents experienced CVD (including 560 stroke and 1306 cardiac events) during the follow-up period. Compared to individuals without depressive symptoms and low hsCRP level, the adjusted hazard ratios (95% confidence intervals) were 1.23(1.09-1.38), 1.41(1.21-1.63) and 1.61(1.40-1.87) for those with high hsCRP level alone, with depressive symptoms alone, with both depressive symptoms and high hsCRP, respectively. There were additive and multiplicative effect of depressive symptoms and inflammation on the risk of CVD, stroke and cardiac events (as categorical variables). Furthermore, we found significant additive and multiplicative interactions of depressive symptoms and inflammation with CVD (as continuous variables).
Conclusion:
Our findings indicated that there was a multiplicative effect of depressive symptoms and inflammation on the risk of CVD. Larger-sample prospective cohort studies are still required to test the potential application of combination of depressive symptoms and inflammation as a screening method to identify individuals at risk of CVD.
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