Association of depression and anxiety with the 10-year risk of cardiovascular mortality in a primary care population of Latvia using the SCORE system
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Date
2018-06
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Abstract
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.
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Funding Information: The authors acknowledge the National Research Program BIOMEDICINE (2014–2017) for funding this study. Ministry of Education and Sciences, Republic of Latvia. Publisher Copyright: Copyright © 2018 Ivanovs, Kivite, Ziedonis, Mintale, Vrublevska and Rancans.
Keywords
10-year cardiovascular mortality risk, Anxiety, Anxiety disorders, Depression, Depressive symptoms, Latvia, SCORE, 3.2 Clinical medicine, 3.3 Health sciences, 1.1. Scientific article indexed in Web of Science and/or Scopus database, Psychiatry and Mental health, SDG 3 - Good Health and Well-being
Citation
Ivanovs, R, Kivite, A, Ziedonis, D, Mintale, I, Vrublevska, J & Rancans, E 2018, 'Association of depression and anxiety with the 10-year risk of cardiovascular mortality in a primary care population of Latvia using the SCORE system', Frontiers in Psychiatry, vol. 9, 276. https://doi.org/10.3389/fpsyt.2018.00276