Depressive Symptoms and Incident Heart Failure in the Jackson Heart Study: Differential Risk Among Black Men and Women.

Abstract

Background Associations between depression, incident heart failure (HF), and mortality are well documented in predominately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all-cause mortality across 10 years. Methods and Results We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clinically significant depressive symptoms at baseline (Center for Epidemiological Studies-Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF (P=0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All-cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only (P=0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms (P=0.043). Conclusions Among Black adults, there were sex-specific associations between depressive symptoms and incident HF, with greater risk among women. Sex-specific management of depression may be needed to improve cardiovascular outcomes.

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Citation

Published Version (Please cite this version)

10.1161/jaha.121.022514

Publication Info

Gaffey, Allison E, Casey E Cavanagh, Lindsey Rosman, Kaicheng Wang, Yanhong Deng, Mario Sims, Emily C O'Brien, Alanna M Chamberlain, et al. (2022). Depressive Symptoms and Incident Heart Failure in the Jackson Heart Study: Differential Risk Among Black Men and Women. Journal of the American Heart Association, 11(5). p. e022514. 10.1161/jaha.121.022514 Retrieved from https://hdl.handle.net/10161/26509.

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Scholars@Duke

O'Brien

Emily O'Brien

Associate Professor in Population Health Sciences

I am an epidemiologist and health services researcher at the Duke Clinical Research Institute. My research focuses on comparative effectiveness, patient-centered outcomes, and pragmatic health services research in cardiovascular and pulmonary disease.

Areas of expertise: Epidemiology, Health Services Research, and Clinical Decision Sciences

Mentz

Robert John Mentz

Associate Professor of Medicine

I am a cardiologist with a clinical and research interest in heart failure (going from Failure to Function), including advanced therapies such as cardiac transplantation and mechanical assist devices or “heart pumps."

I serve our group as Chief of the Heart Failure Section.

I became a heart failure cardiologist in order to help patients manage their chronic disease over many months and years. I consider myself strongly committed to compassionate patient care with a focus on quality of life and patient preference.

I am the Editor in Chief of the Journal of Cardiac Failure - The official journal of the Heart Failure Society of America.

My research interests are focused on treating co-morbid diseases in heart failure patients and improving outcomes across the cardiovascular spectrum through clinical trials and outcomes research. Below, you will find my specific research interests:

  •     Cardiometabolic disease
  •     Co-morbidity characterization (diabetes, sleep apnea, renal failure) in heart failure
  •     Phenotypic characterization and risk prognostication of patients with heart failure
  •     Role of surrogate and nonfatal endpoints in clinical heart failure trials
  •     Biomarkers in heart failure
  •     Novel pharmacological and non-pharmacological approaches to heart failure
  •     Improving site-based heart failure research
Glover

LaShaunta Glover

Medical Instructor in the Department of Population Health Sciences

LaShaunta Glover is an epidemiologist with expertise in cardiovascular, social, and genetic epidemiology. Her research focuses on evaluating and understanding the social determinants of health that exacerbate cardiovascular disease. Her research additionally focuses on exploring social-biological pathways to cardiovascular disease risk with specific focus on OMICs (e.g. epigenomics, proteomics, metabolomics), as a way to understand how social factors lead to upstream cardiovascular disease. Dr. Glover primarily utilizes data from longitudinal cohort studies to understand these associations and is passionate about investigating reasons for health disparities in populations.


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