Depression, anxiety and 6-year risk of cardiovascular disease

Objective: Depression and anxiety are considered etiological factors in cardiovascular disease (CVD), 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 CVD. Methods: DSM-IV diagnoses were established in 2510 CVD-free participants of the Netherlands Study of Depression and Anxiety. Data on subtype, severity, and psychoactive medication were collected. The 6-year incidence of CVD 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. = 2.30; 95%CI 1.10-4.80) was significantly associated with increased CVD 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 CVD onset (e.g., Inventory of Depressive Symptomatology per SD increase: HR. = 1.51; 95%CI 1.25-1.83). Benzodiazepine use was associated with additional CVD risk (HR. = 1.95; 95%CI 1.16-3.31). Conclusions: Current depressive (but not anxiety) disorder independently contributed to CVD in our sample of initially CVD-free participants. CVD incidence over 6. years of follow-up was particularly increased in subjects with more symptoms, and in those using benzodiazepines.