School of Medicine and Health Sciences Poster Presentations

Title

A large retrospective analysis reveals an association between coronary heart disease and history of depression and anxiety

Document Type

Poster

Keywords

coronary heart disease; depression, anxiety

Publication Date

Spring 2017

Abstract

Background: Coronary heart disease (CHD) and myocardial infarction (MI) continue to be leading causes of death in the United States. Effects of depression and anxiety on CHD and MI risk remain controversial. A number of studies have shown mixed results. Even fewer studies have examined the specific association of anxiety with MI. Limitations to existing studies include non-prospective designs, small sample sizes, and review of non-current data. Furthermore, effects of medication use for depression and anxiety on CHD and MI risk have not been fully elucidated. Our study examines the association between CHD/MI and all three of these important factors: anxiety, depression, and psychiatric medications, in a cross-sectional analysis of a large database of subjects in the United States. The large sample size and comprehensive adjustment for risk factors for CHD/MI are major strengths of this study.

Methods: We analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) containing 441,456 subjects. A chi-square test was used to examine the binary variables of demographic and health characteristics of subjects with CHD/MI and subjects without CHD/MI. These characteristics include gender, age, hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), chronic kidney disease (CKD), anxiety, depression, and medications for emotional problems. We then used logistic regression models to estimate the adjusted odds ratio of CHD/MI for these characteristics.

Results: Univariate analysis revealed that being older than 60 years and having HTN, DM, HLD, and CKD significantly increases the odds of CHD/MI by 4.77, 5.03, 3.91, 3.48, and 4.47, respectively. Furthermore, depression and taking medications for emotional problems increases the odds of CHD/MI by approximately 70% with a p-value less than 0.0001. In contrast, anxiety significantly reduces the odds of CHD/MI by 38% with a p-value less than 0.0001. We then constructed two logistic regression models which showed that depression increases the odds of CHD/MI by 2.48, and anxiety reduces the odds of CHD/MI by 58%, after comprehensive adjustment for CHD/MI risk factors. Finally, medications for emotional problems are not associated with CHD/MI, after adjustment for other risk factors as well as depression or anxiety.

Conclusions: A national database was used to determine the associations between CHD/MI, depression, anxiety, and use of medication for emotional problems. Our analysis suggests that depression increases the odds ratio of CHD/MI while anxiety reduces the odds ratio of CHD/MI with medication having no effect. This information is clinically useful in assessing risk of CHD/MI in patients with concomitant mental health disease.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Poster to be presented at GW Annual Research Days 2017.

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A large retrospective analysis reveals an association between coronary heart disease and history of depression and anxiety

Background: Coronary heart disease (CHD) and myocardial infarction (MI) continue to be leading causes of death in the United States. Effects of depression and anxiety on CHD and MI risk remain controversial. A number of studies have shown mixed results. Even fewer studies have examined the specific association of anxiety with MI. Limitations to existing studies include non-prospective designs, small sample sizes, and review of non-current data. Furthermore, effects of medication use for depression and anxiety on CHD and MI risk have not been fully elucidated. Our study examines the association between CHD/MI and all three of these important factors: anxiety, depression, and psychiatric medications, in a cross-sectional analysis of a large database of subjects in the United States. The large sample size and comprehensive adjustment for risk factors for CHD/MI are major strengths of this study.

Methods: We analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) containing 441,456 subjects. A chi-square test was used to examine the binary variables of demographic and health characteristics of subjects with CHD/MI and subjects without CHD/MI. These characteristics include gender, age, hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), chronic kidney disease (CKD), anxiety, depression, and medications for emotional problems. We then used logistic regression models to estimate the adjusted odds ratio of CHD/MI for these characteristics.

Results: Univariate analysis revealed that being older than 60 years and having HTN, DM, HLD, and CKD significantly increases the odds of CHD/MI by 4.77, 5.03, 3.91, 3.48, and 4.47, respectively. Furthermore, depression and taking medications for emotional problems increases the odds of CHD/MI by approximately 70% with a p-value less than 0.0001. In contrast, anxiety significantly reduces the odds of CHD/MI by 38% with a p-value less than 0.0001. We then constructed two logistic regression models which showed that depression increases the odds of CHD/MI by 2.48, and anxiety reduces the odds of CHD/MI by 58%, after comprehensive adjustment for CHD/MI risk factors. Finally, medications for emotional problems are not associated with CHD/MI, after adjustment for other risk factors as well as depression or anxiety.

Conclusions: A national database was used to determine the associations between CHD/MI, depression, anxiety, and use of medication for emotional problems. Our analysis suggests that depression increases the odds ratio of CHD/MI while anxiety reduces the odds ratio of CHD/MI with medication having no effect. This information is clinically useful in assessing risk of CHD/MI in patients with concomitant mental health disease.