Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study

Jessica R. White, Chung Chou H Chang, Kaku A. So-Armah, Jesse C. Stewart, Samir K. Gupta, Adeel A. Butt, Cynthia L. Gibert, David Rimland, Maria C. Rodriguez-Barradas, David A. Leaf, Roger J. Bedimo, John S. Gottdiener, Willem J. Kop, Stephen S. Gottlieb, Matthew J. Budoff, Tasneem Khambaty, Hilary A. Tindle, Amy C. Justice, Matthew S. Freiberg

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background-Both HIV and depression are associated with increased heart failure (HF) risk. Depression, a common comorbidity, may further increase the risk of HF among adults with HIV infection (HIV+). We assessed the association between HIV, depression, and incident HF. Methods and Results-Veterans Aging Cohort Study (VACS) participants free from cardiovascular disease at baseline (n=81 427: 26 908 HIV+, 54 519 without HIV [HIV-]) were categorized into 4 groups: HIV-without major depressive disorder (MDD) [reference], HIV-with MDD, HIV+ without MDD, and HIV+ with MDD. International Classification of Diseases, Ninth Revision codes from medical records were used to determine MDD and the primary outcome, HF. After 5.8 years of follow-up, HF rates per 1000 person-years were highest among HIV+ participants with MDD (9.32; 95% confidence interval [CI], 8.20-10.6). In Cox proportional hazards models, HIV+ participants with MDD had a significantly higher risk of HF (adjusted hazard ratio, 1.68; 95% CI, 1.45-1.95) compared with HIV-participants without MDD. MDD was associated with HF in separate fully adjusted models for HIV-and HIV+ participants (adjusted hazard ratio, 1.21; 95% CI, 1.06-1.37; and adjusted hazard ratio, 1.29; 95% CI, 1.11-1.51, respectively). Among those with MDD, baseline antidepressant use was associated with lower risk of incident HF events (adjusted hazard ratio, 0.76; 95% CI, 0.58-0.99). Conclusions-Our study is the first to suggest that MDD is an independent risk factor for HF in HIV+ adults. These results reinforce the importance of identifying and managing MDD among HIV+ patients. Future studies must clarify mechanisms linking HIV, MDD, antidepressants, and HF and identify interventions to reduce HF morbidity and mortality in those with both HIV and MDD.

Original languageEnglish (US)
Pages (from-to)1630-1638
Number of pages9
JournalCirculation
Volume132
Issue number17
DOIs
StatePublished - Oct 27 2015

Fingerprint

Veterans
Virus Diseases
Major Depressive Disorder
Cohort Studies
Heart Failure
HIV
Depression
Confidence Intervals
Antidepressive Agents
International Classification of Diseases

Keywords

  • Depression
  • Epidemiology
  • Heart failure
  • HIV

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

White, J. R., Chang, C. C. H., So-Armah, K. A., Stewart, J. C., Gupta, S. K., Butt, A. A., ... Freiberg, M. S. (2015). Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study. Circulation, 132(17), 1630-1638. https://doi.org/10.1161/CIRCULATIONAHA.114.014443

Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study. / White, Jessica R.; Chang, Chung Chou H; So-Armah, Kaku A.; Stewart, Jesse C.; Gupta, Samir K.; Butt, Adeel A.; Gibert, Cynthia L.; Rimland, David; Rodriguez-Barradas, Maria C.; Leaf, David A.; Bedimo, Roger J.; Gottdiener, John S.; Kop, Willem J.; Gottlieb, Stephen S.; Budoff, Matthew J.; Khambaty, Tasneem; Tindle, Hilary A.; Justice, Amy C.; Freiberg, Matthew S.

In: Circulation, Vol. 132, No. 17, 27.10.2015, p. 1630-1638.

Research output: Contribution to journalArticle

White, JR, Chang, CCH, So-Armah, KA, Stewart, JC, Gupta, SK, Butt, AA, Gibert, CL, Rimland, D, Rodriguez-Barradas, MC, Leaf, DA, Bedimo, RJ, Gottdiener, JS, Kop, WJ, Gottlieb, SS, Budoff, MJ, Khambaty, T, Tindle, HA, Justice, AC & Freiberg, MS 2015, 'Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study', Circulation, vol. 132, no. 17, pp. 1630-1638. https://doi.org/10.1161/CIRCULATIONAHA.114.014443
White, Jessica R. ; Chang, Chung Chou H ; So-Armah, Kaku A. ; Stewart, Jesse C. ; Gupta, Samir K. ; Butt, Adeel A. ; Gibert, Cynthia L. ; Rimland, David ; Rodriguez-Barradas, Maria C. ; Leaf, David A. ; Bedimo, Roger J. ; Gottdiener, John S. ; Kop, Willem J. ; Gottlieb, Stephen S. ; Budoff, Matthew J. ; Khambaty, Tasneem ; Tindle, Hilary A. ; Justice, Amy C. ; Freiberg, Matthew S. / Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study. In: Circulation. 2015 ; Vol. 132, No. 17. pp. 1630-1638.
@article{89a0b073b4f8467a9eaf18c9d8089b53,
title = "Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study",
abstract = "Background-Both HIV and depression are associated with increased heart failure (HF) risk. Depression, a common comorbidity, may further increase the risk of HF among adults with HIV infection (HIV+). We assessed the association between HIV, depression, and incident HF. Methods and Results-Veterans Aging Cohort Study (VACS) participants free from cardiovascular disease at baseline (n=81 427: 26 908 HIV+, 54 519 without HIV [HIV-]) were categorized into 4 groups: HIV-without major depressive disorder (MDD) [reference], HIV-with MDD, HIV+ without MDD, and HIV+ with MDD. International Classification of Diseases, Ninth Revision codes from medical records were used to determine MDD and the primary outcome, HF. After 5.8 years of follow-up, HF rates per 1000 person-years were highest among HIV+ participants with MDD (9.32; 95{\%} confidence interval [CI], 8.20-10.6). In Cox proportional hazards models, HIV+ participants with MDD had a significantly higher risk of HF (adjusted hazard ratio, 1.68; 95{\%} CI, 1.45-1.95) compared with HIV-participants without MDD. MDD was associated with HF in separate fully adjusted models for HIV-and HIV+ participants (adjusted hazard ratio, 1.21; 95{\%} CI, 1.06-1.37; and adjusted hazard ratio, 1.29; 95{\%} CI, 1.11-1.51, respectively). Among those with MDD, baseline antidepressant use was associated with lower risk of incident HF events (adjusted hazard ratio, 0.76; 95{\%} CI, 0.58-0.99). Conclusions-Our study is the first to suggest that MDD is an independent risk factor for HF in HIV+ adults. These results reinforce the importance of identifying and managing MDD among HIV+ patients. Future studies must clarify mechanisms linking HIV, MDD, antidepressants, and HF and identify interventions to reduce HF morbidity and mortality in those with both HIV and MDD.",
keywords = "Depression, Epidemiology, Heart failure, HIV",
author = "White, {Jessica R.} and Chang, {Chung Chou H} and So-Armah, {Kaku A.} and Stewart, {Jesse C.} and Gupta, {Samir K.} and Butt, {Adeel A.} and Gibert, {Cynthia L.} and David Rimland and Rodriguez-Barradas, {Maria C.} and Leaf, {David A.} and Bedimo, {Roger J.} and Gottdiener, {John S.} and Kop, {Willem J.} and Gottlieb, {Stephen S.} and Budoff, {Matthew J.} and Tasneem Khambaty and Tindle, {Hilary A.} and Justice, {Amy C.} and Freiberg, {Matthew S.}",
year = "2015",
month = "10",
day = "27",
doi = "10.1161/CIRCULATIONAHA.114.014443",
language = "English (US)",
volume = "132",
pages = "1630--1638",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "17",

}

TY - JOUR

T1 - Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study

AU - White, Jessica R.

AU - Chang, Chung Chou H

AU - So-Armah, Kaku A.

AU - Stewart, Jesse C.

AU - Gupta, Samir K.

AU - Butt, Adeel A.

AU - Gibert, Cynthia L.

AU - Rimland, David

AU - Rodriguez-Barradas, Maria C.

AU - Leaf, David A.

AU - Bedimo, Roger J.

AU - Gottdiener, John S.

AU - Kop, Willem J.

AU - Gottlieb, Stephen S.

AU - Budoff, Matthew J.

AU - Khambaty, Tasneem

AU - Tindle, Hilary A.

AU - Justice, Amy C.

AU - Freiberg, Matthew S.

PY - 2015/10/27

Y1 - 2015/10/27

N2 - Background-Both HIV and depression are associated with increased heart failure (HF) risk. Depression, a common comorbidity, may further increase the risk of HF among adults with HIV infection (HIV+). We assessed the association between HIV, depression, and incident HF. Methods and Results-Veterans Aging Cohort Study (VACS) participants free from cardiovascular disease at baseline (n=81 427: 26 908 HIV+, 54 519 without HIV [HIV-]) were categorized into 4 groups: HIV-without major depressive disorder (MDD) [reference], HIV-with MDD, HIV+ without MDD, and HIV+ with MDD. International Classification of Diseases, Ninth Revision codes from medical records were used to determine MDD and the primary outcome, HF. After 5.8 years of follow-up, HF rates per 1000 person-years were highest among HIV+ participants with MDD (9.32; 95% confidence interval [CI], 8.20-10.6). In Cox proportional hazards models, HIV+ participants with MDD had a significantly higher risk of HF (adjusted hazard ratio, 1.68; 95% CI, 1.45-1.95) compared with HIV-participants without MDD. MDD was associated with HF in separate fully adjusted models for HIV-and HIV+ participants (adjusted hazard ratio, 1.21; 95% CI, 1.06-1.37; and adjusted hazard ratio, 1.29; 95% CI, 1.11-1.51, respectively). Among those with MDD, baseline antidepressant use was associated with lower risk of incident HF events (adjusted hazard ratio, 0.76; 95% CI, 0.58-0.99). Conclusions-Our study is the first to suggest that MDD is an independent risk factor for HF in HIV+ adults. These results reinforce the importance of identifying and managing MDD among HIV+ patients. Future studies must clarify mechanisms linking HIV, MDD, antidepressants, and HF and identify interventions to reduce HF morbidity and mortality in those with both HIV and MDD.

AB - Background-Both HIV and depression are associated with increased heart failure (HF) risk. Depression, a common comorbidity, may further increase the risk of HF among adults with HIV infection (HIV+). We assessed the association between HIV, depression, and incident HF. Methods and Results-Veterans Aging Cohort Study (VACS) participants free from cardiovascular disease at baseline (n=81 427: 26 908 HIV+, 54 519 without HIV [HIV-]) were categorized into 4 groups: HIV-without major depressive disorder (MDD) [reference], HIV-with MDD, HIV+ without MDD, and HIV+ with MDD. International Classification of Diseases, Ninth Revision codes from medical records were used to determine MDD and the primary outcome, HF. After 5.8 years of follow-up, HF rates per 1000 person-years were highest among HIV+ participants with MDD (9.32; 95% confidence interval [CI], 8.20-10.6). In Cox proportional hazards models, HIV+ participants with MDD had a significantly higher risk of HF (adjusted hazard ratio, 1.68; 95% CI, 1.45-1.95) compared with HIV-participants without MDD. MDD was associated with HF in separate fully adjusted models for HIV-and HIV+ participants (adjusted hazard ratio, 1.21; 95% CI, 1.06-1.37; and adjusted hazard ratio, 1.29; 95% CI, 1.11-1.51, respectively). Among those with MDD, baseline antidepressant use was associated with lower risk of incident HF events (adjusted hazard ratio, 0.76; 95% CI, 0.58-0.99). Conclusions-Our study is the first to suggest that MDD is an independent risk factor for HF in HIV+ adults. These results reinforce the importance of identifying and managing MDD among HIV+ patients. Future studies must clarify mechanisms linking HIV, MDD, antidepressants, and HF and identify interventions to reduce HF morbidity and mortality in those with both HIV and MDD.

KW - Depression

KW - Epidemiology

KW - Heart failure

KW - HIV

UR - http://www.scopus.com/inward/record.url?scp=84946476744&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946476744&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.114.014443

DO - 10.1161/CIRCULATIONAHA.114.014443

M3 - Article

VL - 132

SP - 1630

EP - 1638

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 17

ER -