Depression, dietary habits, and cardiovascular events among women with suspected myocardial ischemia.

Auteur(s) :
Rutledge TR., Kenkre TS., Thompson DV., Bittner VA., Whittaker K., Eastwood JA., Eteiba W., Cornell CE., Krantz DS., Pepine CJ., Johnson BD., Handberg EM., Bairey Merz CN.
Date :
Avr, 2014
Source(s) :
Am J Med.. #127:9 p840-7
Adresse :
VA San Diego Healthcare System, San Diego, CA; University of California, San Diego, CA. Electronic address: [email protected]

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BACKGROUND
Dietary habits and depression are each associated with cardiovascular disease risk. Patient with depression often report poor eating habits and dietary factors may help explain commonly observed associations between depression and cardiovascular disease.

METHOD
From 1996-2000, 936 women were enrolled in the Women's Ischemia Syndrome Evaluation (WISE) at four US academic medical centers at the time of clinically indicated coronary angiography and then assessed (median follow-up, 5.9 years) for adverse outcomes (cardiovascular disease death, heart failure, myocardial infarction, stroke). Participants completed a protocol including coronary angiography (coronary artery disease severity), depression assessments (Beck Depression Inventory [BDI] scores, antidepressant use, & depression treatment history). A subset of 201 women (mean age= 58.5(SD=11.4) further completed the Food Frequency Questionnaire for Adults (FFQ; 1998 Block). We extracted daily fiber intake and daily servings of fruit and vegetables as measures of dietary habits.

RESULTS
In separate Cox regression models adjusted for age, smoking, and coronary artery disease severity, Beck Depression Inventory scores (HR=1.05, 95% CI=1.01-1.10), antidepressant use (HR=2.4, 95% CI=1.01-5.9) and a history of treatment for depression (HR=2.4, 95%CI=1.1-5.3) were each adversely associated with time to cardiovascular disease outcomes. Fiber intake (HR=.87, 95% CI=.78-.97) and fruit and vegetable consumption (HR=.36, 95% CI=.19-.70) was associated with a decreased time to cardiovascular disease event risk. In models including dietary habits and depression, fiber intake and fruit and vegetable consumption remained associated with time to cardiovascular disease outcomes, whereas depression relationships were reduced by 10-20% and non-significant.

CONCLUSIONS
Among women with suspected myocardial ischemia, we observed consistent relationships between depression, dietary habits, and time to cardiovascular disease events. Dietary habits partly explained these relationships. These results suggest that dietary habits be included in future efforts to identify mechanisms linking depression to cardiovascular disease.

Source : Pubmed
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