Depression and History of Attempted Suicide as Risk Factors for Heart Disease Mortality in Young Individuals
Depression and History of Attempted Suicide as Risk Factors for Heart Disease Mortality in Young Individuals
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DOI：
10.1001/archgenpsychiatry.2011.125
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发表时间：
2011-11-01
影响因子：
--
通讯作者：
Vaccarino, Viola
中科院分区：
文献类型：
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作者：
Shah, Amit J.;Veledar, Emir;Vaccarino, Viola
背景：虽然抑郁症与心血管疾病发病率和死亡率的增加有关，但实际上没有关于抑郁症是否也会增加年轻人患心血管疾病的风险的信息。目的：我们试图确定美国年轻人中单极和双相抑郁症以及自杀未遂史与缺血性心脏病（IHD）和心血管疾病（CVD）死亡率的关系，并检查潜在的性别差异。设计：纵向流行病学研究。背景：美国成年人的全国代表性样本。参与者：从1988-1994年第三次全国健康和营养检查调查中，共有7641名17至39岁的美国成年人。主要结局指标：心血管疾病和IHD死亡率。通过诊断访谈表对单极/双相抑郁症和自杀未遂史进行评估。结果：在14.9年的中位随访后，共有51名受试者（0.67%）死于CVD， 28名受试者（0.37%）死于IHD。抑郁症（538例[7.04%]）和自杀未遂史（419例[5.48%]）均与IHD死亡风险增加相关，抑郁症的校正风险比为3.70 (95% CI, 1.32-10.35)，自杀未遂史的校正风险比为7.12（2.67-18.98）。有抑郁症或自杀未遂史的女性患心血管疾病的调整风险为3倍（调整风险比为3.20 [95% CI, 1.12-9.17]），患IHD的调整风险为14倍（调整风险比为14.57[2.65-80.10]）。男性的相应数字分别为2.37（0.85-6.58）和3.52（1.05-11.76）。结论：在40岁以下的成年人中，抑郁和自杀未遂史是男女CVD和IHD过早死亡的重要独立预测因素。
Context: Although depression is associated with increased cardiovascular morbidity and mortality, there is virtually no information on whether it also increases the risk in young populations.Objectives: We sought to determine the association of unipolar and bipolar depression and a history of attempted suicide with mortality due to ischemic heart disease (IHD) and cardiovascular disease (CVD) in young US adults and to examine potential sex differences.Design: Longitudinal epidemiologic study.Setting: Nationally representative sample of US adults.Participants: A total of 7641 US adults aged 17 to 39 years from the 1988-1994 Third National Health and Nutrition Examination Survey.Main Outcome Measures: Cardiovascular disease and IHD mortality. Unipolar/bipolar depression and a history of attempted suicide were assessed via the Diagnostic Interview Schedule.Results: After a median follow-up of 14.9 years, a total of 51 subjects (0.67%) died of CVD causes and 28 (0.37%) died of IHD. Depression (538 individuals [7.04%]) and history of attempted suicide (419 [5.48%]) were each associated with an increased risk of IHD death, with adjusted hazard ratios of 3.70 (95% CI, 1.32-10.35) for depression and 7.12 (2.67-18.98) for a history of attempted suicide. Women with depression or a history of attempted suicide had a 3-fold adjusted risk of CVD (adjusted hazard ratio, 3.20 [95% CI, 1.12-9.17]) and a 14-fold adjusted risk of IHD (14.57 [2.65-80.10]). Corresponding figures for men were 2.37 (0.85-6.58) and 3.52 (1.05-11.76).Conclusion: In adults younger than 40 years, depression and history of attempted suicide are significant independent predictors of premature CVD and IHD mortality in both sexes.