Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov:312:35-42.
doi: 10.1016/j.atherosclerosis.2020.09.005. Epub 2020 Sep 13.

Subclinical macro and microvascular disease is differently associated with depressive symptoms in men and women: Findings from the SABRE population-based study

Jingyi Wang  1 , Therese Tillin  2 , Alun D Hughes  3 , Marcus Richards  3 , Naveed Sattar  4 , Chloe Park  3 , Nish Chaturvedi  3
Affiliations

Subclinical macro and microvascular disease is differently associated with depressive symptoms in men and women: Findings from the SABRE population-based study

Jingyi Wang et al. Atherosclerosis. 2020 Nov.

Abstract

Background and aims: Mechanisms underlying the association between cardiovascular disease (CVD) and depression are unknown, and sex differences understudied. We investigated associations between a comprehensive set of measures of macro and microvascular disease and depressive symptoms in older men and women.

Methods: We performed cross-sectional analyses of the SABRE (Southall And Brent REvisited) population-based study. Participants (1396) attended clinic between 2008 and 2011 for assessment of subclinical macrovascular (carotid ultrasound, echocardiography, cerebral magnetic resonance imaging) and microvascular (retinopathy, nephropathy) disease, and depression.

Results: Mean age of 1396 participants was 69.5 years, and 76.2% were male. The median (interquartile range) of depression score was 1 [0, 2] for men and 1 [0, 3] for women. All measures of subclinical macro and microvascular disease were adversely associated with depressive symptoms, even when known CVD was excluded. Physical activity partly explained some of these relationships. The association between left atrial dimension index (LADI), a measure of chronic elevated left ventricular filling pressure, and depressive symptoms was stronger in women (regression coefficient 0.23 [95% CI 0.11, 0.35]) than men (0.07 [-0.01, 0.15]), p for interaction 0.06, on multivariable adjustment.

Conclusions: Subclinical macro and microvascular disease is associated with depressive symptoms, even in the absence of established CVD. These were in part accounted for by physical activity. We observed stronger association between LADI and depressive symptoms in women than in men. The beneficial role of physical activity in abrogating the association between subclinical CVD and depression warrants further investigation.

Keywords: Depression; Epidemiology; Risk factors; Sex differences; Vascular diseases.

PubMed Disclaimer

Conflict of interest statement

The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Flow chart showing sample size included in the 20 year follow-up study.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lett H., Ali S., Whooley M. Depression and cardiac function in patients with stable coronary heart disease: findings from the heart and soul study. Psychosom. Med. 2008;70:444–449. - PMC - PubMed
    1. Gottlieb S.S., Khatta M., Friedmann E. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J. Am. Coll. Cardiol. 2004;43:1542–1549. - 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. Wulsin L.R., Singal B.M. Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom. Med. 2003;65:201–210. - PubMed
    1. van Melle J.P., de Jonge P., Spijkerman T.A. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom. Med. 2004;66:814–822. - PubMed

Publication types