Mental health conditions and cardiovascular diseases: association and risk stratification based on genetics, lifestyle, and biomarkers

保留字：心理健康;心血管;危险分层;用于预测心血管疾病（CVD）的流行病学算法通常关注传统的风险因素（例如吸烟）和生物标志物（例如胆固醇），即使流行病学和孟德尔随机化研究已经显示精神健康状况（包括重度抑郁症）是CVD的原因。然而，这种关系还没有得到很好的理解，还有几个重要的问题，例如，这种关联是动脉粥样硬化性CVD特有的，还是扩展到其他CVD，如房颤和心力衰竭？焦虑症是另一种常见的心理健康状况，也能预测心血管疾病吗？抑郁、焦虑和心血管疾病之间的潜在途径是什么？也许更重要的是，为什么有些患有精神健康状况的人会患上CVD，而有些人却不会，这也是难以捉摸的。这提供了一个独特的机会，风险分层的人与心理健康状况的心血管疾病，以及潜在的列入心理健康的一般CVD预测algorithms.Aims：这个博士学位的首要目标将是调查心理健康和CVD之间的关联使用现有的大数据（英国生物银行和初级保健数据），具有以下目标：1.研究焦虑症与CVD类型（ASCVD、AF、HF、PAD）之间的相关性，以及将焦虑添加到现有CVD预测模型（例如AHA/ACC或SCORE）中的任何其他预测效用。探索连接心理健康状况（包括抑郁和焦虑）和CVD的机制途径（介质）3。确定风险因素（遗传学、生活方式、生物标志物）和心理健康与CVD风险之间的任何相互作用

Keywords: Mental health; cardiovascular; risk stratification; epidemiology Algorithms for predicting cardiovascular disease (CVD) often focus on traditional risk factors (e.g. smoking) and biomarkers (e.g. cholesterol) even though epidemiological and Mendelian randomisation studies have shown mental health conditions, including major depressive disorder, to be causal of CVD. However, the relationship is not well understood with several important remaining questions, e.g. Is the association specific to atherosclerotic CVD, or does it extend to other CVDs, such as atrial fibrillation and heart failure? Is anxiety disorder, another common mental health condition, also predictive of CVDs? What are the underlying pathways between depression, anxiety and CVD? Perhaps more importantly, the reasons why some people with mental health conditions developed CVD but some do not is also elusive. This presents a unique opportunity for risk stratifying people with mental health conditions for CVD, as well as to the potential inclusion of mental health in the general CVD prediction algorithms.Aims: The overarching aim of this PhD would be to investigate the association between mental health and CVD using existing big data (UK Biobank and primary care data) with the following objectives:1. To study the association between anxiety disorder and types of CVD (ASCVD, AF, HF, PAD), as well as any additional prediction utility of adding anxiety to existing CVD prediction models (e.g. AHA/ACC or SCORE)2. To explore the mechanistic pathways (mediators) connecting mental health conditions (including depression and anxiety) and CVD3. To identify any interactions between risk factors (genetics, lifestyle, biomarkers) and mental health in relation to the risk of CVD