Association of Depression and Anxiety with Cardiovascular Diseases

ABSTRACT SL15-1

JELENA VRUBLEVSKA
Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia

ROLANDS IVANOVS
Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia

ANDA KIVITE
Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia

ELMARS RANCANS
Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia

ABSTRACT DESCRIPTION

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. Depression has been recognized as independent risk factor for CVD, less is known about anxiety. The Systematic Coronary Risk Evaluation (SCORE) system estimates the 10-year risk of a first fatal atherosclerotic event. During one week period patients 18+ who visited general practitioner at 24 primary care facilities all over the country, were invited to fill in depression and anxiety screening questionnaires and were interviewed with a structured questionnaire. Measurements of height, weight, waist circumference, blood pressure and total cholesterol were done. The Mini International Neuropsychiatric Interview (MINI) was conducted over the telephone by a psychiatrist within 2 weeks. SCORE was assessed using high risk chart. An univariate and hierarchical multivariate analysis has been carried out adjusting for possible sociodemographic and cardiovascular confounding factors. SCORE cut-off 10% (very high risk) has been set for the analysis. The study population consisted of 1569 subjects. In total 23.4% (n=367) comprised patients with SCORE ≥10%. After adjustment for sociodemographic, traditional cardiovascular risk factors and anxiety, depression maintained a statistically significant relation to SCORE ≥10%. Subjects with clinical symptoms of depression had 1.57 (95% CI 1.06-2.33) times higher odds of very high cardiovascular risk. The highest adjusted odds at 4.00 (95% CI 2.62-6.10) had individuals living in the capital of Latvia compared to those living in rural area. After adjustment for sociodemographic, traditional cardiovascular risk factors and depression, current anxiety disorder maintained a statistically significant relation to SCORE ≥10%, but in a preventive way. Subjects with diagnosed anxiety disorder according to the MINI had OR 0.58 (95% CI 0.38-0.90) for having very high cardiovascular mortality risk. It would be advisable to screen all individuals with SCORE ≥10% for depression. Anxiety can possibly have a protective influence on CVD.