Relationship between major depressive disorder, generalized anxiety disorder and coronary artery disease in the US general population

摘要

Objective: To evaluate whether the changes and persistence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) affect the risk of incident coronary artery disease (CAD) in the US general population. Methods: Data was retrieved from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) conducted in 2001/2002 (Wave 1) and 2004/2005 (Wave 2). At both Wave 1 and one year before Wave 2, MDD and GAD were measured using the Alcohol Use Disorders and Associated Disabilities Interview Schedule IV. CAD was considered present at Wave 1 or Wave 2 based on the participants' self -reported physician diagnosis. Relationship between MDD, GAD and CAD was examined using generalized linear regression model. Results: The study included 32,345 participants without CAD at Wave 1, with 3.3% developing CAD at Wave 2. After adjustment, persistence of MDD/GAD and GAD predicted highest risk of developing CAD respectively (MDD/GAD: RR = 2.01, 95% CI: 1.54-2.64; GAD: RR = 2.09, 95% CI: 1.22-3.58), while positive changes predicted lowest risk (MDD/GAD: RR = 1.43, 95% CI: 1.15-1.78; GAD: RR = 1.68, 95% CI: 1.21-2.33). Negative change of MDD is associated with highest risk of developing CAD (RR = 2.07, 95% CI: 1.69-2.54), while positive changes predicted lowest risk (RR = 1.38, 95% CI: 1.11-1.73). Conclusions: Existence of MDD/GAD, MDD, or GAD increase the risk of new -onset CAD. Positive change in MDD and GAD is associated with reduced risk of incident CAD, which highlights the importance of treating MDD and GAD in preventing the development of CAD.