Summary: Depression and cardiovascular disease appear to be closely related due to their links to inflammation and oxidative stress. Researchers say lowering the risks of cardiovascular disease can improve symptoms of depression.
Cardiovascular risk factors are associated with an increased risk of depression in older adults, according to a new study published April 13 in the open-access journal PLOS ONE by Sandra Martín-Peláez of University of Granada, Spain, and colleagues.
Cardiovascular disease and depression are thought to be closely related due to similar risk factors, including inflammation and oxidative stress. Although it has been shown that depression could be a risk factor for developing cardiovascular disease, studies analyzing the potential impact of cardiovascular health on developing depression are scarce.
In the new study, the researchers used data from an ongoing 6-year multi-center randomized trial in Spain which analyzes the effect of a Mediterranean Diet on men aged 55-75 and women aged 60-75 with overweight or obesity. 6,545 individuals with no cardiovascular or endocrine disease at baseline were included in the current analysis.
A cardiovascular risk score according to the Framingham-based REGICOR function was calculated for each person, dividing participants into low (LR), medium (MR), or high/very high (HR) cardiovascular risk groups. Depressive status was gauged using a questionnaire at baseline and after 2 years of follow-up.
At baseline, women in the HR group showed higher odds of depressive status than LR women (OR 1.78 95% CI 1.26-2.50). In addition, among all participants with baseline total cholesterol below 160 mg/mL, MR and HR individuals showed higher odds of depression than LR (MR: OR 1.77 95% CI 1.13-2.77; HR: OR 2.83 95% CI 1.25-6.42).
On the contrary, among participants with total cholesterol of 280 mg/mL or higher, MR and HR individuals had a lower risk of depression than LR (MR: OR 0.26 95% CI 0.07-0.98; HR: OR 0.23 95% CI 0.05-0.95).
After two years, during which time all individuals were instructed to follow a Mediterranean Diet as part of the trial, participants, on average, decreased their depressive status score, with the greatest decreases seen for MR and HR participants with high baseline cholesterol levels.
The authors conclude that high and very high cardiovascular risk are associated with depressive symptoms, especially in women, and that the role of other factors, such as adherence to the Mediterranean Diet, deserves further research.
Funding: The PREDIMED-Plus trial was supported by the European Research Council through a grant to MAM (Advanced Research Grant 2013-2018; 340918).
The project was also supported by the official funding agency for biomedical research of the Spanish Government (ISCIII) through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (four coordinated FIS projects), who awarded grants to JS and JV (PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732 and PI17/00926).
The International Nut&Dried Fruit Council – FESNAD – also provided funding through a grant to MAM (201302), and Recercaixa also awarded a grant to JS (2013ACUP00194). The Department of Health, Generalitat de Cataluña by the calls “Acció instrumental de programes de recerca orientats en làmbit de la recercaila innovació en salut” and “Pla estrategic de recerca i innovació en salut (PERIS),” also awarded a grant to FF (SLT006/17/00246).
This research was also partially funded by: Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); Generalitat Valenciana (PROMETEO/2017/017); SEMERGEN, CIBEROBN, FEDER and ISCIII (CB06/03); EU-H2020 Grants (Eat2beNICE/h2020-sfs-2016-2, ref.728018; PRIME/h2020-SC1-BHC-2018-2020, ref: 847879).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. None of the funding sources took part in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication.
About this depression and cardiovascular disease research news
Author: Hanna Abdallah
Contact: Hanna Abdallah – PLOS
Image: The image is in the public domain
Original Research: Open access.
“Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study” by Sandra Martín-Peláez et al. PLOS ONE
Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study
Cardio-vascular disease and depression are thought to be closely related, due to shared risk factors. The aim of the study was to determine the association between cardio-vascular risk (CVR) factors and depressive status in a population (55–75 years) with metabolic syndrome (MetS) from the PREDIMED-Plus trial.
Methods and findings
Participants were classified into three groups of CVR according to the Framingham-based REGICOR function: (1) low (LR), (2) medium (MR) or (3) high/very high (HR). The Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms at baseline and after 2 years.
The association between CVR and depressive status at baseline (n = 6545), and their changes after 2 years (n = 4566) were evaluated through multivariable regression models (logistic and linear models). HR women showed higher odds of depressive status than LR [OR (95% CI) = 1.78 (1.26, 2.50)]. MR and HR participants with total cholesterol <160 mg/mL showed higher odds of depression than LR [OR (95% CI) = 1.77 (1.13, 2.77) and 2.83 (1.25, 6.42) respectively)] but those with total cholesterol ≥280 mg/mL showed lower odds of depression than LR [OR (95% CI) = 0.26 (0.07, 0.98) and 0.23 (0.05, 0.95), respectively].
All participants decreased their BDI-II score after 2 years, being the decrease smaller in MR and HR diabetic compared to LR [adjusted mean±SE = -0.52±0.20, -0.41±0.27 and -1.25±0.31 respectively). MR and HR participants with total cholesterol between 240–279 mg/mL showed greater decreases in the BDI-II score compared to LR (adjusted mean±SE = -0.83±0.37, -0.77±0.64 and 0.97±0.52 respectively).
Improving cardiovascular health could prevent the onset of depression in the elderly. Diabetes and total cholesterol in individuals at high CVR, may play a specific role in the precise response. International Standard Randomized Controlled Trial (ISRCTN89898870).