Depression and onset of cardiovascular disease in the US middle-aged and older adults

Objectives: To examine the relationship between depression and onset of cardiovascular disease (CVD) among the US middle-aged and older adults. Methods: The study sample came from 1992-2010 waves of the Health and Retirement Study, a nationally representative longitudinal survey, consisting of 8597 community-dwelling adults aged 51-61 years old in 1992 with no CVD history. A score of >= 3 on the 8-item Center for Epidemiologic Studies Depression Scale was used to define clinically relevant depressive symptoms. Kaplan-Meier estimator and Cox proportional hazards model were performed to examine the association between baseline depressive symptoms and future CVD event. Subgroup analyses were conducted by sex and race/ethnicity. Results: Compared with their counterparts without clinically relevant depressive symptoms, adults with clinically relevant depressive symptoms in 1992 were 27% (hazard ratio [HR] = 1.27, 95% confidence interval = 1.17-1.39) more likely to report new diagnosis of CVD during the 18 years of follow-up. A significant dose-response relationship was present between severity of depressive symptoms and elevated CVD risk. The adjusted HRs for males and Hispanics appeared moderately larger than for their female and non-Hispanic white or African American counterparts, although the differences were not statistically significant. Conclusion: Holistic promotion of mental health through prevention, education, treatment, and rehabilitation is warranted to reduce CVD risk in the US middle-aged and older population.