| Title: | Combined impact of depressive and anxiety symptoms and cardiovascular health metrics on major adverse cardiovascular events: A prospective cohort study |
| Journal: | Journal of Affective Disorders |
| Published: | 28 May 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40447155/ |
| DOI: | https://doi.org/10.1016/j.jad.2025.119508 |
Publication 15214
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Abstract
BACKGROUND: The interplay between psychological health and traditional cardiovascular health (CVH) metrics, and their joint impact on the risk of major adverse cardiovascular events (MACE), remain unclear.</p>
METHODS: This study investigated the prospective association of depressive and anxiety symptoms, assessed by Patient Health Questionnaire-4 (PHQ-4) scores, and traditional CVH, measured by Life's Essential 8 (LE8) scores, with MACE risk in the UK Biobank cohort. MACE was defined as a composite of nonfatal myocardial infarction, nonfatal stroke, and cardiovascular mortality. Cox proportional hazards models evaluated the association of LE8 and PHQ-4 with MACE risk.</p>
RESULTS: Among 95,098 participants (mean ± SD age, 55.58 ± 7.75 years; 42,526 [44.72 %] male), 3001 (3.2 %) experienced MACE during a mean follow-up of 12.73 years. Participants with low PHQ-4 scores and ideal CVH had the lowest risk of MACE compared to those with high PHQ-4 scores and poor CVH (HR, 0.263 [95 % CI, 0.183-0.377]). Higher CVH scores were consistently associated with reduced MACE risk, regardless of depressive and anxiety symptoms. Each 10-point increase in LE8 scores was associated with a significantly lower MACE risk in both participants with PHQ-4 scores <6 (HR 0.784, 95 % CI [0.759-0.810]) and with PHQ-4 scores ≥6 (HR 0.782, 95 % CI [0.679-0.901]). These findings remained robust across sensitivity analyses and subgroups.</p>
CONCLUSIONS: Fewer symptoms of depression and anxiety, alongside optimal CVH, are independently and jointly associated with a lower risk of MACE. Integrating psychological health management with CVH optimization may enhance cardiovascular outcomes and reduce the burden of cardiovascular disease.</p>
15 Keywords
- Adult
- Aged
- Anxiety
- Cardiovascular Diseases
- Depression
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
- Proportional Hazards Models
- Prospective Studies
- Risk Factors
- Stroke
- United Kingdom
13 Authors
- Si You
- Wan-Bing He
- Bao-Zhu Li
- Yang-Wei Cai
- Ze-Gui Huang
- Hai-Feng Zhang
- Yu-Biao Wu
- Xu-Hui Wu
- Zhao-Yu Liu
- Jing-Feng Wang
- Shao-Ling Zhang
- Jing-Wei Gao
- Pin-Ming Liu
1 Application
| Application ID | Title |
|---|---|
| 91090 | Predictors of coronary artery calcification (CAC) progression in the UKB population |
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