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Anxiety and Depression Associated With Increased Cardiovascular Disease Risk Through Accelerated Development of Risk Factors. | LitMetric

AI Article Synopsis

  • Prior research was limited in understanding how cardiometabolic risk factors (CVDRFs), like hypertension and diabetes, mediate the link between anxiety/depression and cardiovascular disease (CVD).
  • The study followed over 71,000 participants for a decade to assess the impact of anxiety/depression on the development of CVDRFs and the role of neuro-immune mechanisms, with findings showing a clear association and effect differences based on age and sex.
  • Results indicated that anxiety/depression significantly increases the risk of developing CVDRFs, especially in younger women, and this relationship may be influenced by neuro-immune pathways.

Article Abstract

Background: Prior studies have incompletely assessed whether the development of cardiometabolic risk factors (CVDRF) (hypertension, hyperlipidemia, and diabetes mellitus) mediates the association between anxiety and depression (anxiety/depression) and cardiovascular disease (CVD).

Objectives: The authors aimed to evaluate the following: 1) the association between anxiety/depression and incident CVDRFs and whether this association mediates the increased CVD risk; and 2) whether neuro-immune mechanisms and age and sex effects may be involved.

Methods: Using a retrospective cohort design, Mass General Brigham Biobank subjects were followed for 10 years. Presence and timing of anxiety/depression, CVDRFs, and CVD were determined using ICD codes. Stress-related neural activity, chronic inflammation, and autonomic function were measured by the assessment of amygdalar-to-cortical activity ratio, high-sensitivity CRP, and heart rate variability. Multivariable regression and mediation analyses were employed.

Results: Among 71,214 subjects (median age 49.6 years; 55.3% female), 27,048 (38.0%) developed CVDRFs during follow-up. Pre-existing anxiety/depression associated with increased risk of incident CVDRF (OR: 1.71 [95% CI: 1.59-1.83],  < 0.001) and with a shorter time to their development (β = -0.486 [95% CI: -0.62 to -0.35],  < 0.001). The development of CVDRFs mediated the association between anxiety/depression and CVD events (log-odds: 0.044 [95% CI: 0.034-0.055],  < 0.05). Neuro-immune pathways contributed to the development of CVDRFs ( < 0.05 each) and significant age and sex effects were noted: younger women experienced the greatest acceleration in the development of CVDRFs after anxiety/depression.

Conclusions: Anxiety/depression accelerate the development of CVDRFs. This association appears to be most notable among younger women and may be mediated by stress-related neuro-immune pathways. Evaluations of tailored preventive measures for individuals with anxiety/depression are needed to reduce CVD risk.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375258PMC
http://dx.doi.org/10.1016/j.jacadv.2024.101208DOI Listing

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