Association of Depression and Anxiety With the 10-Year Risk of Cardiovascular Mortality in a Primary Care Population of Latvia Using the SCORE System

Background: Depression and anxiety have been recognized as independent risk factors for both the development and prognosis of cardiovascular (CV) diseases (CVD). The Systematic Coronary Risk Evaluation (SCORE) function measures the 10-year risk of a fatal CVD and is a crucial tool for guiding CV patient management. This study is the first in Latvia to investigate the association of depression and anxiety with the 10-year CV mortality risk in a primary care population. Methods: This cross-sectional study was conducted at 24 primary care facilities. During a 1-week period in 2015, all consecutive adult patients were invited to complete a nine-item Patient Health Questionnaire (PHQ-9) and a seven-item Generalized Anxiety Disorder scale (GAD-7) followed by sociodemographic questionnaire and physical measurements. The diagnostic Mini International Neuropsychiatric Interview (M.I.N.I.) was administered by telephone in the period of 2 weeks after the first contact at the primary care facility. A hierarchical multivariate analysis was performed. Results: The study population consisted of 1,569 subjects. Depressive symptoms (PHQ-9 ≥10) were associated with a 1.57 (95% confidence interval (CI): 1.06-2.33) times higher odds of a very high CV mortality risk (SCORE ≥10%), but current anxiety disorder (M.I.N.I.) reduced the CV mortality risk with an odds ratio of 0.58 (95% CI: 0.38-0.90). Conclusions: Our findings suggest that individuals with SCORE ≥10% should be screened and treated for depression to potentially delay the development and improve the prognosis of CVD. Anxiety could possibly have a protective influence on CV prognosis

Anxiety · Association (psychology · Depression (economics · Environmental health · Family medicine · Population · Primary care · Psychiatry · Blood Pressure and Hypertension Studies · Cardiac Health and Mental Health · Heart Rate Variability and Autonomic Control · Medicine · Psychology

• Anxiety Disorders in Primary Care

  Open Access•Kurt Kroenke, Robert L Spitzer et al.•Annals of Internal Medicine•2007

  Añadir item

• European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)

  Authors/Task Force Members, Joep Perk et al.•European Heart Journal•2012

  Añadir item

• Estimation of ten-year risk of fatal cardiovascular disease in Europe

  Richard Conroy•European Heart Journal•2003

  Añadir item

• Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015

  Open Access•Haidong Wang, Mohsen Naghavi et al.•The Lancet•2016

  Añadir item

• Anxiety and Risk of Incident Coronary Heart Disease

  Open Access•Annelieke M Roest, Elisabeth J Martens et al.•Journal of the American College…•2010

  Añadir item

• Effect of Potentially Modifiable Risk Factors Associated With Myocardial Infarction in 52 Countries (The Interheart Study)

  Open Access•Semir Yusuf, Salim Yusuf et al.•The Lancet•2004

  Añadir item

• A Brief Measure for Assessing Generalized Anxiety Disorder

  Robert L Spitzer, Carmen Pérez de los Ríos et al.•A.M.A. Archives of Internal…•2006

  Añadir item

• The PHQ-9

  Kurt Kroenke, Robert L Spitzer et al.•Journal of General Internal…•2001

  Añadir item

• The role of conceptual frameworks in epidemiological analysis

  Cesar G Victora, Sharon Huttly et al.•International Journal of…•1997

  Añadir item

• Role of Cardiac Disease Severity in the Predictive Value of Anxiety for All-Cause Mortality

  Thomas Meyer, Ullrich Buss et al.•Psychosomatic Medicine•2010

  Añadir item

• A Meta-Analysis of Mental Health Treatments and Cardiac Rehabilitation for Improving Clinical Outcomes and Depression Among Patients With Coronary Heart Disease

  Thomas Rutledge, Laura S Redwine et al.•Psychosomatic Medicine•2013

  Añadir item

• Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia

  Open Access•Rolands Ivanovs, A Kivite et al.•BMC Public Health•2018

  Añadir item