HealthDay News — Patients with depression are significantly more likely to have both prevalent and incident peripheral artery disease (PAD), but other cardiovascular risk factors likely explain the association, study findings suggest.
Patients who were depressed had higher baseline PAD rates (12% vs. 7%) and higher rates of PAD-related events during follow-up (7% vs. 5%), Marlene Grenon, MD, from the University of California San Francisco, and colleagues reported at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology 2012 Scientific Sessions in Chicago.
However, after accounting for age, race, comorbidities, medication use, PAD risk factors, inflammation, and health behaviors, depressed patients were no more likely than their nondepressed peers to have PAD, the researchers found.
Risk factors for PAD and coronary artery disease (CAD) are known to overlap, and although previous research has linked depression and CAD, little was known about the association between PAD and depression. “In view of continued high morbidity and mortality associated with [PAD], the need for adjunctive modalities in the prevention and treatment of [the disease] remains critical,” Grenon and colleagues wrote on a poster presented at the meeting.
So they analyzed data from 1,024 men and women with CAD, recruited from 2000 to 2002, to further explore the topic. The validated nine-item Patient Health Questionnaire was used to evaluate depression at baseline, and PAD was determined by self-report. Participants were followed for a mean of 7.2 years, and less than 5% of the participant group was lost to follow-up.
At baseline, the researchers found that depression affected 19% of patients. Prevalent PAD was reported by 12.1% and 7.3% of patients with and without depression, respectively (age-adjusted odds ratio, 1.79; P = 0.03). But after adjusting for age, more than 5% of the correlation between prevalent PAD and depression was accounted for by each of the following: physical inactivity, diabetes and C-reactive protein level.
During follow-up, PAD events occurred in 9% and 6% of those with and without depression, respectively (age-adjusted hazard ratio, 1.77; P = 0.04). More than 5% of this association was explained by each of the following: inactivity, diabetes, prevalent PAD, race/ethnicity, smoking, high-density lipoprotein cholesterol levels and triglyceride levels.
The factors most strongly involved in mediating the association between depression and incident events were white race, congestive heart failure, smoking and levels of serum creatinine, interleukin-6 and physical activity.