Related Experiment Video
Updated: May 15, 2026
An Unpredictable Chronic Mild Stress Protocol for Instigating Depressive Symptoms, Behavioral Changes and Negative Health Outcomes in Rodents
Published on: December 2, 2015
Association between depressive symptoms and atherosclerotic cardiovascular disease: a Swedish population-based cohort
Christian Rausch1,2,3, Saadbin Zafar Mahmood4, Yajun Liang5
1Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Christian.philipp.rausch@ki.se.
Insights
Depressive symptoms significantly increase the risk of atherosclerotic cardiovascular disease (ASCVD), including premature cases. Early identification and management of depression may be crucial for cardiovascular disease prevention.
Area of Science:
- Cardiology
- Psychiatry
- Epidemiology
Background:
- Atherosclerotic cardiovascular disease (ASCVD) is a major global health concern.
- Traditional risk factors for ASCVD are well-known, but the link between depressive symptoms and ASCVD, especially premature ASCVD, requires further investigation.
Purpose of the Study:
- To investigate the association between depressive symptoms, including severity and anxious distress, and the risk of ASCVD and premature ASCVD in a Swedish population.
- To determine if depressive symptoms independently predict ASCVD risk.
Main Methods:
- Utilized data from the PART study, a longitudinal cohort of 11,175 adults in Stockholm, Sweden.
- Assessed depressive symptoms using the Major Depression Inventory from 1998-2010 and identified ASCVD cases via the National Patient Register until 2021.
- Employed Cox regression models, adjusting for multiple covariates, to analyze hazard ratios (HRs) and 95% confidence intervals (95% CIs).
Main Results:
- Depressive symptoms were associated with a 42% increased risk of ASCVD (HR 1.42).
- The risk extended to ischemic heart disease (HR 1.39) and stroke (HR 1.53), with varying associations based on symptom severity and presence of anxious distress.
- A significant association was found between depressive symptoms and premature ASCVD (HR 1.52), particularly mild depressive symptoms (HR 1.61).
Conclusions:
- Depressive symptoms are linked to an increased risk of ASCVD and premature ASCVD in the Swedish population.
- Highlights the importance of considering depressive symptoms in cardiovascular risk assessment and prevention strategies.
- Suggests future research on the impact of early identification and treatment of depression on cardiovascular outcomes.
Background:
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality globally. While traditional risk factors such as hypertension, smoking, and dyslipidemia are well established, the role of depressive symptoms in ASCVD development, particularly in premature cases, is less understood. This study aims to determine the association between depressive symptoms, including severity and anxious distress as specifiers, with ASCVD and premature ASCVD in a Swedish population-based cohort.
Methods:
We utilized data from the PART study (acronym in Swedish for: Psykisk hälsa, Arbete och RelaTioner: Mental Health, Work and Relationships), a longitudinal cohort study which include a total of 11,175 adults in Stockholm, Sweden. Depressive symptoms were assessed using the Major Depression Inventory across three waves from 1998 to 2010 Incident ASCVD cases were identified through the National Patient Register (NPR) until 2021. Premature ASCVD was defined as occurring before age 55 in men and 65 in women. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs), adjusting for sociodemographic factors, lifestyle behaviors, and cardiometabolic conditions.
Results:
Participants with depressive symptoms had a 42% increased risk of ASCVD (HR 1.42, 95% CI 1.19-1.68), independent of traditional cardiovascular risk factors. When stratifying by ASCVD type, depressive symptoms were associated with ischemic heart disease (HR 1.39, CI 1.06-1.83) and stroke (HR 1.53, CI 1.15-2.05). The risk varied by severity, with mild depressive symptoms associated with ischemic heart disease (HR 1.62, CI 1.11-2.37) and moderate (HR 1.70, 95% CI 1.04-2.78) and severe depressive symptoms (HR 1.61, 95% CI 1.04-2.49) were associated with stroke. Furthermore, participants with combined depressive symptoms and anxious distress had an increased risk of stroke (HR 1.50, CI 1.09-2.07), whereas participants with depressive symptoms without anxious distress had an increased risk of ischemic heart disease (HR 1.88, CI 1.25-2.82). The risk of premature ASCVD was increased among individuals with depressive symptoms (HR = 1.52, 95% CI 1.12-2.05). When examined by level of severity, only among subjects with mild depressive symptoms, a statistically significant association with premature ASCVD (HR = 1.61, 95% CI 1.05-2.48) was found.
Conclusions:
This study provides evidence linking depressive symptoms to ASCVD and premature ASCVD in a Swedish population. The findings underscore the need to consider the effects of depressive symptoms as well as potential prevention strategies for depressive symptoms in regard to cardiovascular diseases. Future research should explore whether early identification and treatment of depressive symptoms can mitigate ASCVD risk and improve long-term cardiovascular outcomes.
Related Concept Videos
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:30Coronary Artery Disease I: Introduction
01:26Atherosclerosis III: Management
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:26Coronary Artery Disease IV: Preventive Measures
01:30Atherosclerosis I: Introduction