Depressive symptoms are associated with incident coronary heart disease or revascularization among blacks but not among whites in the Reasons for Geographical and Racial Differences in Stroke study

Mario Sims, Nicole Redmond, Yulia Khodneva, Raegan W Durant, Jewell Halanych, Monika M Safford
Annals of Epidemiology 2015, 25 (6): 426-32

PURPOSE: To examine the association of depressive symptoms with coronary heart disease (CHD) end points by race and income.

METHODS: Study participants were blacks and whites (n = 24,443) without CHD at baseline from the national Reasons for Geographical and Racial Differences in Stroke cohort. Outcomes included acute CHD and CHD or revascularization. We estimated race-stratified multivariate Cox proportional hazards models of incident CHD and incident CHD or revascularization with the 4-item Center for Epidemiological Studies Depression Scale, adjusting for risk factors.

RESULTS: Mean follow-up was 4.2 ± 1.5 years; CHD incidence was 8.3 events per 1000 person-years (n = 366) among blacks and 8.8 events per 1000 person-years (n = 613) among whites. After adjustment for age, sex, marital status, region, and socioeconomic status, depressive symptoms were significantly associated with incident CHD among blacks (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.00-1.91) but not among whites (HR, 1.10; 95% CI, 0.74-1.64). In the fully adjusted model, compared with blacks who reported no depressive symptoms, those reporting depressive symptoms had greater risk for the composite end point of CHD or revascularization (HR, 1.36; 95% CI, 1.01-1.81). Depressive symptoms were not associated with incident CHD end points among whites.

CONCLUSIONS: High depressive symptoms were associated with higher risk of CHD or revascularization for blacks but not whites.

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