Depressive Symptoms and Incident Heart Failure Risk in the Southern Community Cohort Study

Debra D. Dixon, Meng Xu, Elvis A. Akwo, Devika Nair, David Schlundt, Thomas J. Wang, William J. Blot, Loren Lipworth, Deepak K. Gupta

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: This study aims to examine whether greater frequency of depressive symptoms associates with increased risk of incident heart failure (HF). Background: Depressive symptoms associate with adverse prognosis in patients with prevalent HF. Their association with incident HF is less studied, particularly in low-income and minority individuals. Methods: We studied 23,937 Black or White Southern Community Cohort Study participants (median age: 53 years, 70% Black, 64% women) enrolled between 2002 and 2009, without prevalent HF, receiving Centers for Medicare and Medicaid Services coverage. Cox models adjusted for traditional HF risk factors, socioeconomic and behavioral factors, social support, and antidepressant medications were used to quantify the association between depressive symptoms assessed at enrollment via the Center for Epidemiologic Studies Depression Scale (CESD-10) and incident HF ascertained from Centers for Medicare and Medicaid Services International Classification of Diseases-9th Revision (ICD-9) (code: 428.x) and ICD-10 (codes: I50, I110) codes through December 31, 2016. Results: The median CESD-10 score was 9 (IQR: 5 to 13). Over a median 11-year follow-up, 6,081 (25%) participants developed HF. The strongest correlates of CESD-10 score were antidepressant medication use, age, and socioeconomic factors, rather than traditional HF risk factors. Greater frequency of depressive symptoms associated with increased incident HF risk (per 8-U higher CESD-10 HR: 1.04; 95% CI: 1.00 to 1.09; P = 0.038) without variation by race or sex. The association between depressive symptoms and incident HF varied by antidepressant use (interaction-P = 0.03) with increased risk among individuals not taking antidepressants. Conclusions: In this high-risk, low-income, cohort of predominantly Black participants, greater frequency of depressive symptoms significantly associates with higher risk of incident HF.

Original languageEnglish (US)
Pages (from-to)254-262
Number of pages9
JournalJACC: Heart Failure
Volume10
Issue number4
DOIs
StatePublished - Apr 2022

Keywords

  • Center for Epidemiologic Studies Depression Scale
  • depression
  • heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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