Effect of gender on the association between cumulative cardiovascular risk factors and depression: results from the US National Health and Nutrition Examination Survey

Li, Sen; Jia, Zhaoqi; Zhang, Zhang; Li, Yuxin; Ding, Yu; Qin, Zongshi; Guo, Shuzhen

doi:10.1136/gpsych-2023-101063

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…In addition, some studies have used cumulative risk models to clarify that many CVD risk factors have certain effects on depression. 37 However, each CVD was robustly associated with antidepressant use, including a 74% increased likelihood of antidepressant use associated with overall CVD. The reason behind the increased probability of using antidepressants due to CVD, without a corresponding increase in MDD, can be attributed to two factors.…”

Section: Discussionmentioning

confidence: 99%

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Cao,

Baranova,

Zhao

et al. 2024

BMJ Ment Health

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BackgroundMental disorders have a high comorbidity with cardiovascular disease (CVD), but the causality between them has not been fully appreciated.ObjectiveThis study aimed to systematically explore the bidirectional causality between the two broad categories of diseases.MethodsWe conducted Mendelian randomisation (MR) and multivariable MR (MVMR) analyses to evaluate potential causal links between 10 mental disorders, the use of antidepressants and 7 CVDs.FindingsWe discovered that major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD) and insomnia exhibit connections with elevated risks of two or more CVDs. Moreover, the use of antidepressants is linked to heightened risks of each CVD. Each distinct CVD is correlated with a greater probability of taking antidepressants. Our MVMR analysis demonstrated that the use of antidepressants is correlated with the elevation of respective risks across all cardiovascular conditions. This includes arrhythmias (OR: 1.28), atrial fibrillation (OR: 1.44), coronary artery disease (OR: 1.16), hypertension (OR: 1.16), heart failure (OR: 1.16), stroke (OR: 1.44) and entire CVD group (OR: 1.35). However, MDD itself was not linked to a heightened risk of any CVD.ConclusionsThe findings of our study indicate that MDD, insomnia and ADHD may increase the risk of CVD. Our findings highlight the utilisation of antidepressants as an independent risk factor for CVD, thus explaining the influence of MDD on CVD through the mediating effects of antidepressants.Clinical implicationsWhen treating patients with antidepressants, it is necessary to take into consideration the potential beneficial and detrimental effects of antidepressants.

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Section: Discussionmentioning

confidence: 99%

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Cao,

Baranova,

Zhao

et al. 2024

BMJ Ment Health

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“…(2) We further investigated the stability of the mediating effect of sleep disturbance by including medications used for treating sleep disturbance as covariates. (3) Given that the risk of depression in women is approximately twice that in men ( 29 ) and that research has indicated that there are sex differences in the association between depressive symptoms and CVD ( 30 ), we further explored the mediating role of sleep disturbance across both sexes. (4) Finally, considering that late-life depression is a complex, heterogeneous syndrome closely associated with numerous severe health consequences ( 31 ), we validated the mediating effects of sleep disturbance after stratification by age (younger than 60 years of age and 60 years and older).…”

Section: Methodsmentioning

confidence: 99%

The mediating role of sleep disturbance in the relationship between depression and cardiovascular disease

Chen,

Lin,

Zhang

et al. 2024

Front. Psychiatry

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BackgroundStudies suggest that both depression and disrupted sleep disturbance are linked to cardiovascular disease (CVD). However, the precise role of sleep disturbance in the connection between depression and CVD is poorly understood. Therefore, we sought to examine the associations among these factors and further explore the mediating role of sleep disturbance in the association between depression and CVD.MethodsThis study included data from 29,831 adults (≥20 years old). Multifactorial logistic regression analyses were conducted to examine the relationships among depression, sleep disturbance, and CVD. Additionally, bootstrap tests were used to investigate whether the association between depression and CVD was mediated by sleep disturbance.ResultsOur research showed that individuals who experienced depression or sleep disturbance had a notably greater likelihood of developing CVD than those who did not have these issues (depression: OR: 2.21, 95% CI=1.96–2.49; sleep disturbance: OR: 1.74, 95% CI=1.6–1.9). Even after adjusting for potential confounders, depression was still positively associated with the risk of sleep disturbance (OR: 4.07, 95% CI=3.73–4.44). Furthermore, sleep disturbance significantly mediated the association between depression and CVD, with a mediating effect of 18.1%.ConclusionOur study demonstrated that depression, sleep disturbance, and CVD are interrelated. The increased risk of CVD among patients with depression may be attributed to the mediating role of sleep disturbance. This finding underscores the importance of interventions focused on sleep disturbances as a means to address the connection between depression and CVD.

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“…[17] MR is becoming an increasingly powerful tool in epidemiology and human biology. Genomic wide association studies (GWAS) are often used to determine genetic variants to be investigated in MR. Depression is reported to be associated with several traditional cardiovascular risk factors, [18,19] such as smoking behavior, [20] physical activity, [21] and obesity. [22] Also, these factors are thought to be associated with hypercholesterolemia risk in various studies.…”

Section: Introductionmentioning

confidence: 99%

Causal relationship between depression and hypercholesterolemia: A bidirectional 2-sample Mendelian randomization study

Zhang,

Song

2024

Medicine

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Although observational studies have found both a positive and negative association between depression and hypercholesterolemia, the findings are mixed and contradictory. To our knowledge, this is the first study that employs the bidirectional Mendelian randomization (MR) and multivariable MR analysis with extensive genome-wide association studies (GWAS) data to examine the causal effect between depression and hypercholesterolemia. Using summary statistics obtained from GWAS of individuals with European ancestry, we utilize a bidirectional 2-sample MR approach to explore the potential causal association between hypercholesterolemia and depressive symptoms. Multivariable Mendelian randomization analysis was used to examine whether the direct causal effect of depression on the risk of hypercholesterolemia can be affected by traits associated with the increased risk of hypercholesterolemia. This MR analysis utilized inverse variance weighted (IVW), MR-Egger regression, weighted mode, and weighted median methods. Data on the summary level of depression were acquired from a GWAS that involved 500,199 participants. We used summary GWAS datasets for hypercholesterolemia including 206,067 participants. We also used another GWAS databases of hypercholesterolemiat (n = 463,010) to validate our results. By utilizing IVW, it was discovered that there is a possibility of a 31% rise in the risk of hypercholesterolemia due to depression (OR = 1.31, 95% CI = 1.10–1.57, P = .002). We found a consistent causal effect of depression on hypercholesterolemia from the IVW analyses using different hypercholesterolemia datasets. After adjustment of smoking, physical activity, and obesity, there remains significant causal relationship between depression and hypercholesterolemia (OR = 1.25, 95% CI = 1.01–1.54, P = .040). However, we did not find any evidence indicating that hypercholesterolemia leads to depression in the opposite direction. Directional pleiotropy was not observed in the MR-Egger regression analysis. Additionally, the MR-PRESSO analysis validated these discoveries. Neither the leave-one-out sensitivity test nor the funnel plots revealed any outliers. In both the unadjusted and adjusted estimates, depression has a consistent direct causal effect on hypercholesterolemia. Our study has led to an improved comprehension of the causal connections between hypercholesterolemia and depression, which could aid in the prevention and treatment of hypercholesterolemia.

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Effect of gender on the association between cumulative cardiovascular risk factors and depression: results from the US National Health and Nutrition Examination Survey

Cited by 3 publications

References 36 publications

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

The mediating role of sleep disturbance in the relationship between depression and cardiovascular disease

Causal relationship between depression and hypercholesterolemia: A bidirectional 2-sample Mendelian randomization study

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