Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study
Background Depressive symptoms are risk factors for several forms of cardiovascular disease including coronary heart disease (CHD). However, it is unclear whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with pres...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022818 |
| _version_ | 1797849621070872576 |
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| author | Yulia Khodneva Parag Goyal Emily B. Levitan Elizabeth A. Jackson Suzanne Oparil Madeline R. Sterling Andrea L. Cherrington Raegan Durant Monika M. Safford |
| author_facet | Yulia Khodneva Parag Goyal Emily B. Levitan Elizabeth A. Jackson Suzanne Oparil Madeline R. Sterling Andrea L. Cherrington Raegan Durant Monika M. Safford |
| author_sort | Yulia Khodneva |
| collection | DOAJ |
| description | Background Depressive symptoms are risk factors for several forms of cardiovascular disease including coronary heart disease (CHD). However, it is unclear whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with preserved (HFpEF) or reduced ejection fraction (HFrEF). Methods and Results Among 26 268 HF‐free participants in the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, a prospective biracial cohort of US community‐dwelling adults ≥45 years, baseline depressive symptoms were defined as a score ≥4 on the 4‐item Center for Epidemiologic Studies Depression scale. Incident HF hospitalizations were expert‐adjudicated and categorized as HFpEF (EF ≥50%) and HFrEF, including mid‐range EF (EF<50%). Over a median of 9.2 [IQR 6.2–10.9] years of follow‐up, there were 872 incident HF hospitalizations, 526 among those without CHD and 334 among those with CHD. The age‐adjusted HF hospitalization incidence rates per 1000 person‐years were 4.9 (95% CI 4.0–5.9) for participants with depressive symptoms versus 3.2 (95% CI 3.0–3.5) for those without depressive symptoms (P<0.001). For overall HF, the elevated risk became attenuated after controlling for covariates. When HFpEF was assessed separately, depressive symptoms were associated with incident hospitalization after controlling for all covariates (hazard ratio [HR] 1.48, 95% CI 1.00–2.18) among those without baseline CHD. In contrast, depressive symptoms were not associated with incident HFrEF hospitalizations. Conclusions Among individuals free of CHD at baseline, depressive symptoms were associated with incident hospitalization for HFpEF, but not for HFrEF, or among those with baseline CHD. |
| first_indexed | 2024-04-09T18:47:01Z |
| format | Article |
| id | doaj.art-2bd952a53c804b14a87ad36f018ed95d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T18:47:01Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-2bd952a53c804b14a87ad36f018ed95d2023-04-10T11:57:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-04-0111710.1161/JAHA.121.022818Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS StudyYulia Khodneva0Parag Goyal1Emily B. Levitan2Elizabeth A. Jackson3Suzanne Oparil4Madeline R. Sterling5Andrea L. Cherrington6Raegan Durant7Monika M. Safford8Department of Medicine School of Medicine University of Alabama at Birmingham ALDivision of Internal Medicine Weill Cornell University New York NYDepartment of Epidemiology School of Public Health University of Alabama at Birmingham ALDepartment of Medicine School of Medicine University of Alabama at Birmingham ALDepartment of Medicine School of Medicine University of Alabama at Birmingham ALDivision of Internal Medicine Weill Cornell University New York NYDepartment of Medicine School of Medicine University of Alabama at Birmingham ALDepartment of Medicine School of Medicine University of Alabama at Birmingham ALDivision of Internal Medicine Weill Cornell University New York NYBackground Depressive symptoms are risk factors for several forms of cardiovascular disease including coronary heart disease (CHD). However, it is unclear whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with preserved (HFpEF) or reduced ejection fraction (HFrEF). Methods and Results Among 26 268 HF‐free participants in the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, a prospective biracial cohort of US community‐dwelling adults ≥45 years, baseline depressive symptoms were defined as a score ≥4 on the 4‐item Center for Epidemiologic Studies Depression scale. Incident HF hospitalizations were expert‐adjudicated and categorized as HFpEF (EF ≥50%) and HFrEF, including mid‐range EF (EF<50%). Over a median of 9.2 [IQR 6.2–10.9] years of follow‐up, there were 872 incident HF hospitalizations, 526 among those without CHD and 334 among those with CHD. The age‐adjusted HF hospitalization incidence rates per 1000 person‐years were 4.9 (95% CI 4.0–5.9) for participants with depressive symptoms versus 3.2 (95% CI 3.0–3.5) for those without depressive symptoms (P<0.001). For overall HF, the elevated risk became attenuated after controlling for covariates. When HFpEF was assessed separately, depressive symptoms were associated with incident hospitalization after controlling for all covariates (hazard ratio [HR] 1.48, 95% CI 1.00–2.18) among those without baseline CHD. In contrast, depressive symptoms were not associated with incident HFrEF hospitalizations. Conclusions Among individuals free of CHD at baseline, depressive symptoms were associated with incident hospitalization for HFpEF, but not for HFrEF, or among those with baseline CHD.https://www.ahajournals.org/doi/10.1161/JAHA.121.022818depressionincident heart failurepreventionrisk factors |
| spellingShingle | Yulia Khodneva Parag Goyal Emily B. Levitan Elizabeth A. Jackson Suzanne Oparil Madeline R. Sterling Andrea L. Cherrington Raegan Durant Monika M. Safford Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease depression incident heart failure prevention risk factors |
| title | Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study |
| title_full | Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study |
| title_fullStr | Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study |
| title_full_unstemmed | Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study |
| title_short | Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study |
| title_sort | depressive symptoms and incident hospitalization for heart failure findings from the regards study |
| topic | depression incident heart failure prevention risk factors |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022818 |
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