美国退伍军人的抑郁症和心力衰竭
Jamie L Pfaff1, Svetlana K Eden2, Suman Kundu3
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|May 8, 2025
概括
退伍军人的抑郁症诊断与患心力衰竭 (HF) 的风险更高有关. 这种关联甚至在没有其他健康状况的个体中也存在,这凸显了心理健康查对心血管健康的重要性.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 抑郁症和心力衰竭 (HF) 是影响数百万成年人的普遍疾病.
- 在抑郁症诊断后患上HF的风险尚未得到充分了解.
- 这项研究调查了美国退伍军人中流行抑郁症和发生的高血压之间的联系.
研究的目的:
- 检查美国退伍军人中流行抑郁症和患心力衰竭 (HF) 风险之间的关联.
- 了解抑郁症对大量退伍军人的心血管健康结果的影响.
主要方法:
- 一项队列研究分析了来自退伍军人事务 (VA) 出生队列的美国退伍军人的社会人口统计和临床数据.
- 数据从VA企业数据仓库 (2000-2015年) 收集.
- 事件HF是由特定的诊断代码定义的;抑郁症是使用ICD-9/ICD-10代码识别的. 使用了考克斯的比例危险回归模型.
主要成果:
- 该研究包括超过280万退伍军人,其中8.0%的人在基线时患有流行抑郁症.
- 与没有抑郁症的退伍军人相比,患有抑郁症的退伍军人显示出更高的未经调整的HF事件率 (1万人年136.9),而没有抑郁症的退伍军人则 (1万人年114.6).
- 在对共变量进行调整后,抑郁症与发生高血压风险增加14.0%有关 (HR,1.14;95% CI,1.13-1.16). 在没有并发症的患者中,这种关联甚至更强烈 (HR,1.58).
结论:
- 抑郁症与退伍军人中心力衰竭的风险增加有关,即使考虑到人口和心血管风险因素.
- 在患有抑郁症的人群中,高风险的HF是一致的,尤其在没有并发症的低风险队列中显著.
- 调查结果强调了在对退伍军人的心血管风险评估和管理策略中考虑心理健康的重要性.
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