Depression is a risk factor for coronary artery disease in men - The precursors study
Depression is a risk factor for coronary artery disease in men - The precursors study
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DOI：
10.1001/archinte.158.13.1422
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发表时间：
1998-07-13
影响因子：
--
通讯作者：
Klag, MJ
中科院分区：
文献类型：
--
作者：
Ford, DE;Mead, LA;Klag, MJ
背景资料：几项研究发现，抑郁是临床冠状动脉疾病发作后预后不良的独立预测因子。有很少的数据有关抑郁症作为一个危险因素的发展冠状动脉diseases.Objective：要确定临床抑郁症是否是一个独立的危险因素，为事件coronary artery diseases.Patients和方法：约翰霍普金斯前驱研究是一个前瞻性的，观察性研究1190名男性医学生谁是1948年和1964年之间注册，并继续进行随访。在医学院和随访期间，收集了有关家族史、健康行为和临床抑郁症的信息。心血管疾病的终点进行了评估，每年的问卷调查，国家死亡指数搜索，医疗记录，死亡证明，和尸检reports.Results的审查：临床抑郁症的累积发病率在医学生在40年的后续是12%。患有临床抑郁症的男性比没有患临床抑郁症的男性喝更多的咖啡，但在基线血压、血清胆固醇水平、吸烟状况、体力活动、肥胖或冠状动脉疾病家族史方面没有差异。在多变量分析中，报告临床抑郁症的男性发生冠心病（相对危险度[RR]，2.12; 95%置信区间[CI]，1.24-3.63）和心肌梗死（RR，2.12; 95% CI，1.11-4.06）的风险显著更高。与临床抑郁症相关的风险增加，即使是心肌梗死发生后10年的第一次抑郁发作（RR，2.1; 95%CI，1.1-4.0）。结论：临床抑郁症似乎是一个独立的危险因素，冠心病事件发生后几十年的临床抑郁症发作。
Background: Several studies have found that depression is an independent predictor of poor outcome after the onset of clinical coronary artery disease. There are few data concerning depression as a risk factor for the development of coronary artery disease.Objective: To determine if clinical depression is an independent risk factor for incident coronary artery disease.Patients and Methods: The Johns Hopkins Precursors Study is a prospective, observational study of 1190 male medical students who were enrolled between 1948 and 1964 and who continued to be followed up. In medical school and through the follow-up period, information was collected on family history, health behaviors, and clinical depression. Cardiovascular disease end points have been assessed with reviews of annual questionnaires, National Death index searches, medical records, death certificates, and autopsy reports.Results: The cumulative incidence of clinical depression in the medical students at 40 years of follow-up was 12%. Men who developed clinical depression drank more coffee than those who did not but did not differ in terms of baseline blood pressure, serum cholesterol levels, smoking status, physical activity, obesity, or family history of coronary artery disease. In multivariate analysis, the men who reported clinical depression were at: significantly greater risk for subsequent coronary heart disease (relative risk [RR], 2.12; 95% confidence interval [CI], 1.24-3.63) and myocardial infarction (RR, 2.12; 95% CI, 1.11-4.06). The increased risk associated with clinical depression was present even for myocardial infarctions occurring 10 years after the onset of the first depressive episode (RR, 2.1; 95% CI, 1.1-4.0).Conclusion: Clinical depression appears to be an independent risk factor for incident coronary artery disease for several decades after the onset of the clinical depression.