Depression, anxiety and 6-year risk of cardiovascular disease

Objective: Depression and anxiety are considered etiological factors in cardiovascular disease (ND), though their relative contribution and differentiation by clinical characteristics have not been studied intensively. We examined 6-year associations between depressive and anxiety disorders, clinical characteristics and newly-developed ND. Methods: DSM-IV diagnoses were established in 2510 DID-free participants of the Netherlands Study of Depression and Anxiety. Data on subtype, severity, and psychoactive medication were collected. The 6-year incidence of ND was assessed using Cox regression analyses adjusted for sociodemographic, health and lifestyle factors. Results: One-hundred-six subjects (4.2%) developed CVD. Having both current depressive and anxiety disorders (HR = 2.86, 95%CI 1.49-5.49) or current depression only (HR = 230; 95%CI 1.10-4.80) was significantly associated with increased ND incidence, whereas current anxiety only (HR = 1.48; 95%CI 0.74-2.96) and remitted disorders (HR = 1.48; 95%CI 0.80-2.75) were not associated. Symptom severity was associated with increased ND onset (e.g., Inventory of Depressive Symptomatology per SD increase: HR = 1.51; 95%CI 125-1.83). Benzodiazepine use was associated with additional ND risk (HR = 1.95; 95%CI 1.16-331). Conclusions: Current depressive (but not anxiety) disorder independently contributed to CVD in our sample of initially DID-free participants. DID incidence over 6 years of follow-up was particularly increased in subjects with more symptoms, and in those using benzodiazepines. (C) 2014 Elsevier Inc. All rights reserved.