Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia: a cross-sectional study

Abstract

BackgroundCardiovascular (CV) diseases (CVDs) are the leading cause of mortality worldwide. Globally, there is a growing interest in understanding and addressing modifiable psychosocial risk factors, particularly depression and anxiety, to prevent CVDs and to reduce morbidity and mortality. Despite the high premature mortality rate from CVDs in Latvia, this is the first Latvian study to examine the association of depression and anxiety with CVD morbidity in a primary care population.MethodsThis cross-sectional study was carried out in 2015 within the framework of the National Research Program BIOMEDICINE at 24 primary care facilities throughout Latvia. Consecutive adult patients during a one-week time period at each facility were invited to join the study. Assessments onsite included a 9-item Patient Health Questionnaire (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7) followed by a socio-demographic questionnaire and measurements of height, weight, waist circumference, blood pressure, and total cholesterol. The diagnostic Mini International Neuropsychiatric Interview (MINI) was conducted over the telephone within 2 weeks after the visit to the general practitioner. A multivariate model was developed using binary logistic regression.ResultsFrom the 1565 subjects (31.2% male), CVD was detected in 17.1%. Depression screening was positive (PHQ-9 ≥ 10) for 14.7%, and anxiety screening was positive (GAD-7 ≥ 10) for 10.1% of the study subjects. According to the MINI, 10.3% had current and 28.1% had lifetime depressive episode, and 16.1% had an anxiety disorder. Depression, not anxiety, was statistically significantly related to CVDs with an odds ratio (OR) of 1.52 (p = 0.04) for current depressive symptoms (PHQ-9 ≥ 10) and 2.08 (p = 0.002) for lifetime depressive episode (MINI).ConclusionsCurrent depressive symptoms (PHQ-9 ≥ 10) and a lifetime depressive episode (according to the MINI) were significantly associated with increased risk of CV morbidity. Therefore, CV patients should be screened and treated for depression to potentially improve the prognosis of CVDs. Enhanced training and integration of mental health treatment in Latvian primary care settings may improve clinical outcomes.

Assessment of the Gail Model in Estimating the Risk of Breast Cancer: Effect of Cancer Worry and Risk in Healthy Women

“…Furthermore, PHQ -9 and GAD-7 appears to be a reliable and valid instrument that can be used to diagnose major depression (18.5%) and anxiety (15.2%) among Turkish women. This is consistent the with prevalence rate of major depression and anxiety observed rates 15.4% and 14.4% in United States among women (Elrashidi et al, 2018), also similarly study reported for the depression 14.7%, and anxiety 10.1% conducted in Latvia women (Ivanovs et al, 2018).…”

Classical Risk Factors and Inflammatory Biomarkers: One of the Missing Biological Links between Cardiovascular Disease and Major Depressive Disorder

“…Cardio- and cerebrovascular disorders are recognized worldwide as the most frequent causes for death and major depressive disorder (MDD) for disability [ 1 ]. In recent cross-sectional studies, repeatedly an association of current depressive symptoms and lifetime depressive episodes with cardiovascular disease (CVD), could be confirmed [ 2 ]. MDD represents a major risk factor for CVD and for myocardial infarction (MI) [ 3 ] independent of traditional risk factors [ 4 ], this seems to be especially true in geriatric depression [ 5 ].…”

Association of Depression and Anxiety With the 10-Year Risk of Cardiovascular Mortality in a Primary Care Population of Latvia Using the SCORE System

“…The prevalence of elevated symptoms of anxiety in CV patients has been reported to be approximately 30% ( 12 , 14 ). Data on the relationship between depression, anxiety and CVD from the Baltic region are limited and controversial ( 15 – 17 ).…”