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. 2004 Dec;19(12):1192-9.
doi: 10.1111/j.1525-1497.2004.30405.x.

Cardiac risk factors in patients with diabetes mellitus and major depression

Wayne J Katon  1 , Elizabeth H B Lin, Joan Russo, Michael Von Korff, Paul Ciechanowski, Greg Simon, Evette Ludman, Terry Bush, Bessie Young
Affiliations

Cardiac risk factors in patients with diabetes mellitus and major depression

Wayne J Katon et al. J Gen Intern Med. 2004 Dec.

Abstract

Objective: The prevalence of major depression is approximately 2-fold higher in patients with diabetes mellitus compared to medical controls. We explored the association of major depression with 8 cardiac risk factors in diabetic patients with and without evidence of cardiovascular disease (CVD).

Design: A mail survey questionnaire was administered to a population-based sample of 4,225 patients with diabetes to obtain data on depression status, diabetes self-care (diet, exercise, and smoking), diabetes history, and demographics. On the basis of automated data we measured diabetes complications, glycosylated hemoglobin, medical comorbidity, low-density lipid levels, triglyceride levels, diagnosis of hypertension, and evidence of microalbuminuria. Separate analyses were conducted for subgroups according to the presence or absence of CVD.

Setting: Nine primary care clinics of a nonprofit health maintenance organization.

Main results: Patients with major depression and diabetes were 1.5- to 2-fold more likely to have 3 or more cardiovascular risk factors as patients with diabetes without depression (62.5% vs 38.4% in those without CVD, and 61.3% vs 45% in those with CVD). Patients with diabetes without CVD who met criteria for major depression were significantly more likely to be smokers, to have a body mass index (BMI) > or = 30 kg/m2, to lead a more sedentary lifestyle, and to have HbA1c levels of >8.0% compared to nondepressed patients with diabetes without heart disease. Patients with major depression, diabetes, and evidence of heart disease were significantly more likely to have a BMI > or = 30 kg/m2, a more sedentary lifestyle, and triglyceride levels > 400 mg/dl than nondepressed diabetic patients with evidence of heart disease.

Conclusions: Patients with major depression and diabetes with or without evidence of heart disease have a higher number of CVD risk factors. Interventions aimed at decreasing these risk factors may need to address treatment for major depression in order to be effective.

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Figures

FIGURE 1
FIGURE 1
Mail survey description.
See this image and copyright information in PMC

References

    1. Kannel W, McGee D, Gordon T. A general cardiovascular risk profile: the Framingham Study. Am J Cardiol. 1976;38:46–51. - PubMed
    1. Strike P, Steptoe A. Depression, stress and the heart. Heart. 2002;88:441–3. - PMC - PubMed
    1. Hemingway H, Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary artery disease. BMJ. 1999;318:1460–7. - PMC - PubMed
    1. Rugulies R. Depression as a predictor for coronary heart disease. A review and meta-analysis. Am J Prev Med. 2002;23:51–61. - PubMed
    1. Frasure-Smith, Lesperance F, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995;91:999–1005. - PubMed

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