Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study
Abstract Background Studies suggest increased risk for an outcome in people with joint exposures that share common causal pathways. The objective of this study was to determine the risk of incident acute myocardial infarction (AMI) following exposure to both albuminuria and/or anxiety and depression...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02921-1 |
| _version_ | 1828330243903979520 |
|---|---|
| author | Lise Tuset Gustad Tor Åge Myklebust Ottar Bjerkeset Lana J. Williams Lars Erik Laugsand Håvard Dalen Michael Berk Solfrid Romundstad |
| author_facet | Lise Tuset Gustad Tor Åge Myklebust Ottar Bjerkeset Lana J. Williams Lars Erik Laugsand Håvard Dalen Michael Berk Solfrid Romundstad |
| author_sort | Lise Tuset Gustad |
| collection | DOAJ |
| description | Abstract Background Studies suggest increased risk for an outcome in people with joint exposures that share common causal pathways. The objective of this study was to determine the risk of incident acute myocardial infarction (AMI) following exposure to both albuminuria and/or anxiety and depression symptoms. Methods Participants who provided urine samples to the HUNT2 (1995–97) or HUNT3 (2007–2009) surveys were followed until the end of 2016. Albuminuria was measured by Albumin Creatine Ratio (ACR) and participants self-reported mood and anxiety symptoms on the Hospital Anxiety and Depression scale. We used Cox regression to estimate hazard ratios (HRs) for first incident AMI considering interaction between exposures and additive models to calculate the proportion of AMI that were attributable to the synergy of both exposures, adjusted for the Framingham variables. Results Eleven thousand fourteen participants free of previous AMI were eligible for participation, with 1234 incident AMIs occurred during a mean 13.7 years of follow-up. For participants who had a healthier CVD risk profile, the HR for AMI of having both albuminuria (3–30 mg/mmol) and depression (≥8) was 2.62 (95% 1.12–6.05) compared with a HR 1.34 (95% CI 1.04–1.74) with raised ACR only (Likelihood Ratio-test 0.03). Adding anxiety (≥8) to albuminuria (3–30) tripled the risk (HR 3.32 95% CI 1.43–7.17). The additive models suggest that these risks are not higher than expected based on each risk factor alone. Conclusions This study indicate that the risk of AMI in persons with elevated albuminuria but with an otherwise healthy CVD profile might be amplified by anxiety and depression symptoms. The increased risk with joint risk factors is not higher than expected based on each risk factor alone, which indicate that the risk factors do not share causal pathways. |
| first_indexed | 2024-04-13T20:36:35Z |
| format | Article |
| id | doaj.art-dd1a121a595f4fe29dae10880ebbdf7f |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-13T20:36:35Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-dd1a121a595f4fe29dae10880ebbdf7f2022-12-22T02:31:01ZengBMCBMC Cardiovascular Disorders1471-22612022-11-0122111110.1186/s12872-022-02921-1Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort studyLise Tuset Gustad0Tor Åge Myklebust1Ottar Bjerkeset2Lana J. Williams3Lars Erik Laugsand4Håvard Dalen5Michael Berk6Solfrid Romundstad7Faculty of Nursing and Health Sciences, Nord University, LevangerDepartment of Registration, Cancer Registry of NorwayFaculty of Nursing and Health Sciences, Nord University, LevangerDeakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthDepartment of Emergency Medicine, St. Olavs Hospital, Trondheim University HospitalFaculty of Nursing and Health Sciences, Nord University, LevangerDepartment of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital TrustDepartment of Circulation and Medical Imaging, Medicine and health sciences, Norwegian University of Science and Technology (NTNU)Abstract Background Studies suggest increased risk for an outcome in people with joint exposures that share common causal pathways. The objective of this study was to determine the risk of incident acute myocardial infarction (AMI) following exposure to both albuminuria and/or anxiety and depression symptoms. Methods Participants who provided urine samples to the HUNT2 (1995–97) or HUNT3 (2007–2009) surveys were followed until the end of 2016. Albuminuria was measured by Albumin Creatine Ratio (ACR) and participants self-reported mood and anxiety symptoms on the Hospital Anxiety and Depression scale. We used Cox regression to estimate hazard ratios (HRs) for first incident AMI considering interaction between exposures and additive models to calculate the proportion of AMI that were attributable to the synergy of both exposures, adjusted for the Framingham variables. Results Eleven thousand fourteen participants free of previous AMI were eligible for participation, with 1234 incident AMIs occurred during a mean 13.7 years of follow-up. For participants who had a healthier CVD risk profile, the HR for AMI of having both albuminuria (3–30 mg/mmol) and depression (≥8) was 2.62 (95% 1.12–6.05) compared with a HR 1.34 (95% CI 1.04–1.74) with raised ACR only (Likelihood Ratio-test 0.03). Adding anxiety (≥8) to albuminuria (3–30) tripled the risk (HR 3.32 95% CI 1.43–7.17). The additive models suggest that these risks are not higher than expected based on each risk factor alone. Conclusions This study indicate that the risk of AMI in persons with elevated albuminuria but with an otherwise healthy CVD profile might be amplified by anxiety and depression symptoms. The increased risk with joint risk factors is not higher than expected based on each risk factor alone, which indicate that the risk factors do not share causal pathways.https://doi.org/10.1186/s12872-022-02921-1DepressionAlbuminuriaRiskCardiovascular diseaseMood disorderAnxiety |
| spellingShingle | Lise Tuset Gustad Tor Åge Myklebust Ottar Bjerkeset Lana J. Williams Lars Erik Laugsand Håvard Dalen Michael Berk Solfrid Romundstad Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study BMC Cardiovascular Disorders Depression Albuminuria Risk Cardiovascular disease Mood disorder Anxiety |
| title | Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study |
| title_full | Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study |
| title_fullStr | Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study |
| title_full_unstemmed | Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study |
| title_short | Anxiety and depression symptoms, albuminuria and risk of acute myocardial infarction in the Norwegian HUNT cohort study |
| title_sort | anxiety and depression symptoms albuminuria and risk of acute myocardial infarction in the norwegian hunt cohort study |
| topic | Depression Albuminuria Risk Cardiovascular disease Mood disorder Anxiety |
| url | https://doi.org/10.1186/s12872-022-02921-1 |
| work_keys_str_mv | AT lisetusetgustad anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT toragemyklebust anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT ottarbjerkeset anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT lanajwilliams anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT larseriklaugsand anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT havarddalen anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT michaelberk anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy AT solfridromundstad anxietyanddepressionsymptomsalbuminuriaandriskofacutemyocardialinfarctioninthenorwegianhuntcohortstudy |