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BACKGROUND: Depression affects more people than any other mental health disorder and is the world’s leading cause of disability. Depression has been commonly associated with chronic conditions such as cardiovascular disease (CVD), cancer, arthritis and diabetes. CVD is the leading cause of death in both the United States and Indiana. Depression symptoms have been associated with worse prognosis in patients with CVD and with increased risk for CVD. We examined the association between depression and CVD among Indiana adults.
METHODS: We used data from the 2011-2013 Indiana Behavioral Risk Factor Surveillance System (BRFSS), to examine whether self-reported depression varies between adults who self-reported CVD. Respondents were asked if a doctor, nurse, or other health professional ever told them they had depression. CVD was defined as yes to any of the following one questions – “Has a doctor, nurse, or health professional ever told you that you had any of the following: 1. A heart attack, also called a myocardial infarction, 2. Angina or coronary heart disease, and 3. A stroke.” Demographics and risk factors were controlled for in the analysis. Weighted adjusted prevalence ratios and multivariate analyses were conducted using SAS Survey Procedure.
RESULTS: Of the 17,140 respondents, 3,364 (20%) self-reported diagnoses of lifetime depression. Of Indiana adults, 9.7% self-reported diagnoses of CVD. Of those adults with CVD, respondents reported significantly more depression then those without diagnoses of CVD (33.3% CI: 30.6-35.90 vs. 18.6% CI: 17.8-19.5). Adults with CVD were 2.4 (CI: 2.1-2.9) times more likely of having depression as compared to adults without CVD, controlling for demographics. In reviewing risk factors for CVD, adults with depression reported higher prevalence of blood pressure (42% vs. 31%), physical inactivity (36.8% vs. 25.1%), smoking (37.4% vs. 21.6%), and obesity (40.1% vs. 28.9%).
CONCLUSIONS: The prevalence of depression was significantly higher among adults who self-reported CVD compared to those without CVD, regardless of age, gender, income, race and education. Adults with CVD risk factors reported significantly more depression than those without risk factors. These results suggest that depression can be a risk factor for CVD and should be addressed. Health care providers treating adults for CVD should also screen and treat for depression to improve treatment outcome.