Depression and Heart Failure in US Veterans
Jamie L Pfaff1, Svetlana K Eden2, Suman Kundu3
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA Network Open
|May 8, 2025
Summary
Depression diagnosis in veterans is linked to a higher risk of developing heart failure (HF). This association persists even in individuals without other health conditions, highlighting the importance of mental health screening for cardiovascular health.
Area of Science:
- Cardiology
- Psychiatry
- Epidemiology
Background:
- Depression and heart failure (HF) are prevalent conditions affecting millions of adults.
- The risk of developing HF after a depression diagnosis is not well-understood.
- This study investigates the link between prevalent depression and incident HF in US veterans.
Purpose of the Study:
- To examine the association between prevalent depression and the risk of developing incident heart failure (HF) among US veterans.
- To understand the impact of depression on cardiovascular health outcomes in a large veteran population.
Main Methods:
- A cohort study analyzing sociodemographic and clinical data of US veterans from the Veterans Affairs (VA) Birth Cohort.
- Data were collected from the VA Corporate Data Warehouse (2000-2015).
- Incident HF was defined by specific diagnostic codes; depression was identified using ICD-9/ICD-10 codes. A Cox proportional hazards regression model was employed.
Main Results:
- The study included over 2.8 million veterans, with 8.0% having prevalent depression at baseline.
- Veterans with depression showed higher unadjusted incident HF rates (136.9 per 10,000 person-years) compared to those without (114.6 per 10,000 person-years).
- After adjusting for covariates, depression was associated with a 14.0% increased hazard of incident HF (HR, 1.14; 95% CI, 1.13-1.16). The association was even stronger in patients without comorbidities (HR, 1.58).
Conclusions:
- Depression is significantly associated with an increased hazard of incident heart failure in the veteran population, even after accounting for demographic and cardiovascular risk factors.
- The elevated risk of HF in individuals with depression was consistent, particularly notable in a low-risk cohort without comorbidities.
- Findings underscore the importance of considering mental health in cardiovascular risk assessment and management strategies for veterans.
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