Depression leads to incident vascular disease: Evidence for the relevance to primary care

Jeffrey F. Scherrer, Joanne Salas, Jay A. Brieler, Bobbi J. Miller, Dixie Meyer, F. David Schneider

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. Depression is a known risk factor for vascular disease in community cohorts and in large, system-wide, health care databases. It is not known if the association between depression and incident vascular disease exists when patient data is restricted to depression presenting in primary care. Methods. Data were from a medical record registry capturing all primary care encounters at a large academic medical practice from 2008 to 2013. From 27 225 registry patients, we identified 7383 patients free of vascular disease for 18 months prior to baseline. ICD-9-CM codes were used to define depression and vascular disease. Volume of health care use, demographics and comorbid diagnoses were obtained from the patient data registry. Cox proportional hazard models with time dependent covariates were computed to measure the association between depression and incident vascular disease before and after adjusting for covariates. Results. Of the 7383 patients initially free of vascular disease, 14% were diagnosed with depression and 8.6% developed vascular disease. Incident vascular disease was significantly (P < 0.01) higher among patients with depression (12.7%) compared to those without depression (7.9%). In the unadjusted model, depression was associated with a 49% increased risk of developing vascular disease (odds ratio [OR] = 1.49; 95% confidence interval [CI]: 1.19-1.86) and this association remained significant after adjusting for all potential confounders (OR = 1.28; 95% CI: 1.02-1.62). Conclusions. The association between depression and incident vascular disease is observed in patients diagnosed and managed by primary care physicians. Primary care physicians have an opportunity to impact this association. Guidelines for primary care providers are needed to prompt aggressive depression treatment and vascular disease screening.

Original languageEnglish (US)
Pages (from-to)147-151
Number of pages5
JournalFamily Practice
Volume32
Issue number2
DOIs
StatePublished - Apr 1 2015

Fingerprint

Vascular Diseases
Primary Health Care
Registries
Primary Care Physicians
Odds Ratio
Confidence Intervals
Delivery of Health Care
Managed Care Programs
International Classification of Diseases
Proportional Hazards Models
Medical Records
Demography
Databases
Guidelines

Keywords

  • Depression
  • Heart disease
  • Primary care
  • Stroke
  • Vascular disease

ASJC Scopus subject areas

  • Family Practice

Cite this

Depression leads to incident vascular disease : Evidence for the relevance to primary care. / Scherrer, Jeffrey F.; Salas, Joanne; Brieler, Jay A.; Miller, Bobbi J.; Meyer, Dixie; David Schneider, F.

In: Family Practice, Vol. 32, No. 2, 01.04.2015, p. 147-151.

Research output: Contribution to journalArticle

Scherrer, Jeffrey F. ; Salas, Joanne ; Brieler, Jay A. ; Miller, Bobbi J. ; Meyer, Dixie ; David Schneider, F. / Depression leads to incident vascular disease : Evidence for the relevance to primary care. In: Family Practice. 2015 ; Vol. 32, No. 2. pp. 147-151.
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