Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms

Smolderen, Kim G.; Spertus, John A.; Vriens, Patrick W.; Kranendonk, Steef; Nooren, Maria; Denollet, Johan

doi:10.1016/j.jvs.2010.04.025

Cited by 29 publications

(18 citation statements)

References 36 publications

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“…This finding has been previously demonstrated at diagnosis and long‐term follow‐up, specifically, younger women with PAD are known to be at a higher risk of depression than other gender age groups. 6 Depressive symptoms or “mood states” as well as a greater degree of bodily pain may be associated with substantially compromised functional status 48 as well as a poorer prognosis, 49 which ultimately has adverse effects on patients' health status. 50–51 When we adjusted for depression scores, after including other relevant demographic, socio‐economic, and cardiovascular risk factors, we found further attenuation in the association between gender and health status for physical health status at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…With these factors in mind, the current longitudinal study was designed to assess gender‐based differences in health status and long‐term adverse prognosis, including exploring the explanatory role of depressive symptoms for these outcomes since women are known to have worse depressive symptoms than men with PAD, and depressive symptoms have provided part of the explanation for adverse outcomes in cardiovascular disorders. 6,17 …”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Dreyer¹,

Zitteren

Beltrame

et al. 2015

JAHA

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BackgroundFew studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease (PAD). This study assessed (1) self‐reported health status at PAD diagnosis and 12‐months later, and explored (2) whether outcomes in women with PAD differ with regard to long‐term major adverse events.Methods and ResultsA total of 816 patients (285 women) with PAD were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form‐12 (SF‐12, Physical Component Score [PCS] and Mental Component Score [MCS]) upon PAD diagnosis and 12‐months later. Women had similar ages and clinical characteristics, but poorer socio‐economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical (PCS: 37±10 versus 40±10, P=0.004) and mental (MCS: 47±12 versus 49±11, P=0.005) health status at the time of presentation. At 12‐months, women still reported a poorer overall PCS score (41±12 versus 46±11, P=0.006) and MCS score (42±14 versus 49±12, P=0.002). Female gender was an independent determinant of a poorer baseline and 12‐month PCS and MCS scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [HR]=0.93, 95% CI 0.60;1.44, P=0.74) or major adverse events (unadjusted HR=0.90, 95% CI 0.63;1.29, P=0.57), after a median follow‐up of 3.2 years.ConclusionsWomen's physical and mental health status is compromised both at initial PAD diagnosis and at 12‐month follow‐up, despite experiencing a similar magnitude of change in their health scores throughout the first 12‐months after diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Dreyer¹,

Zitteren

Beltrame

et al. 2015

JAHA

Self Cite

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“…Studies of patients with long-term depressive or anxiety disorders revealed elevated incidence of sub-clinical cardiovascular disease, as measured by a variety of parameters including plaque deposition and arterial stiffness (Seldenrijk et al, 2013), and blood pressure, glucose, body mass index (BMI), diet, and physical activity (Kronish et al, 2012). Interestingly, and relevant to sex differences often observed in the context of anxiety and depressive disorders [for which prevalence can be as twice higher in women compared to men, see Bekker and van Mens-Verhulst (2007); Kimbro et al (2012)], significant depressive symptoms are more common in younger women with peripheral arterial disease than in other gender-age groups (Smolderen et al, 2010). Also, recent meta-analysis of cardiovascular risk factors and depression in later life demonstrated relatively strong associations between depression and diabetes, cardiovascular disease and stroke (Valkanova and Ebmeier, 2013).…”

Section: Systemic Disorders Associated With Depressionmentioning

confidence: 99%

Mind and body: how the health of the body impacts on neuropsychiatry

2013

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It has long been established in traditional forms of medicine and in anecdotal knowledge that the health of the body and the mind are inextricably linked. Strong and continually developing evidence now suggests a link between disorders which involve Hypothalamic-Pituitary-Adrenal axis (HPA) dysregulation and the risk of developing psychiatric disease. For instance, adverse or excessive responses to stressful experiences are built into the diagnostic criteria for several psychiatric disorders, including depression and anxiety disorders. Interestingly, peripheral disorders such as metabolic disorders and cardiovascular diseases are also associated with HPA changes. Furthermore, many other systemic disorders associated with a higher incidence of psychiatric disease involve a significant inflammatory component. In fact, inflammatory and endocrine pathways seem to interact in both the periphery and the central nervous system (CNS) to potentiate states of psychiatric dysfunction. This review synthesizes clinical and animal data looking at interactions between peripheral and central factors, developing an understanding at the molecular and cellular level of how processes in the entire body can impact on mental state and psychiatric health.

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“…13-16 Prior research has also indicated that women with PAD below the age of 65 years are particularly vulnerable to experiencing depressive symptoms and that these symptoms seem to be accompanied with high rates of smoking. 17 …”

Section: Introductionmentioning

confidence: 99%

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

Grenon

Cohen

Smolderen

et al. 2014

Journal of Vascular Surgery

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Background Despite the high prevalence of peripheral artery disease (PAD) in women, risk factors for PAD in women are not well understood. Methods Gender-specific risk factors for PAD were examined in a prospective cohort study of 1024 patients (184 women and 840 men) with stable coronary artery disease who were recruited between 2000 to 2002. Logistic regression models were used to evaluate associations between traditional and non-traditional risk factors and PAD in both men and women. Results 11% of women and 13% of men were found to have PAD. Women with PAD had a similar prevalence of traditional risk factors (hypertension, hyperlipidemia, and smoking) compared to women without PAD. Women with PAD were significantly more likely to suffer from depression than women without PAD. Men with PAD were more likely to have hypertension, diabetes mellitus, a history of smoking, a worse lipid profile and higher levels of inflammatory biomarkers compared to men without PAD. In a multivariate model, depression was the only significant factor associated with PAD in women while smoking and elevated fibrinogen were independently associated with PAD in men. Conclusions The current findings suggest gender differences in risk factors for the development of PAD. Further research is needed to understand the role of depression in PAD.

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Younger women with symptomatic peripheral arterial disease are at increased risk of depressive symptoms

Cited by 29 publications

References 36 publications

Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease

Mind and body: how the health of the body impacts on neuropsychiatry

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

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