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Symptoms of anxiety and depression and risk of heart failure: the HUNT Study
Author(s) -
Gustad Lise T.,
Laugsand Lars E.,
Janszky Imre,
Dalen Håvard,
Bjerkeset Ottar
Publication year - 2014
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.133
Subject(s) - medicine , anxiety , depression (economics) , hazard ratio , prospective cohort study , myocardial infarction , heart failure , cohort , population , cohort study , psychiatry , confidence interval , environmental health , economics , macroeconomics
Aims Symptoms of anxiety and depression often co‐exist with cardiovascular disease, yet little is known about the prospective risk for heart failure ( HF ) in people with symptoms of depression and anxiety. We aimed to study these prospective associations using self‐reported symptoms of anxiety, depression, and mixed symptoms of anxiety and depression ( MSAD ) in a large population sample. Methods and results In the second wave of the Nord‐Trøndelag Health Study ( HUNT 2, 1995–1997), Norway, baseline data on symptoms of anxiety and depression, socio‐demographic variables, health status including cardiovascular risk factors, and common chronic somatic diseases were registered for 62 567 adults, men and women, free of known HF . The cohort was followed for incident HF from baseline throughout 2008. A total of 1499 cases of HF occurred during a mean follow‐up of 11.3 years ( SD = 2.9), identified either in hospital registers or by the National Cause of Death Registry. There was no excess risk for future HF associated with symptoms of anxiety or MSAD at baseline. For depression, the multi‐adjusted hazard ratios for HF were 1.07 (0.87–1.30) for moderate symptoms and 1.41 (1.07–1.87) for severe symptoms ( P for trend 0.026). Established cardiovascular risk factors, acute myocardial infarction ( AMI ) prior to baseline, and adjustment for incident AMI as a time‐dependent covariate during follow‐up had little influence on the estimates. Conclusion Symptoms of depression, but not symptoms of anxiety or MSAD , were associated with increased risk for HF in a dose–response manner. The increased risk could not be fully explained by cardiovascular or socio‐economic risk factors, or by co‐morbid AMI .