Depressive Symptoms Significantly Associated With Mortality and Cardiovascular Disease

Adults with moderate to severe depression were found to have a higher all-cause risk of ischemic heart and cardiovascular disease (CVD) mortality than adults without depression, according to a prospective cohort study published in JAMA Network Open.

“Taken together with the body of literature on associations between depression and CVD mortality, these findings can support public health efforts to develop a comprehensive, nationwide strategy to improve well-being, including both mental and cardiovascular health,” study authors noted. 

The research, conducted between 2005 and 2019, included 23,694 participants, with a mean age of 44.7 years. Depressive symptoms were categorized as none or minimal, mild, and moderate to severe using Patient Health Questionnaire-9 (PHQ-9) scores. Participants were sourced with the National Health and Nutrition Examination Survey 2005 to 2018 and participant data was linked with the National Death Index through the year 2019 for adults 20 years and older. Data were analyzed between March 1, 2023, and May 26, 2023.

Participants with mild depressive symptoms exhibited a 35% higher risk of all-cause mortality and a 49% higher risk of CVD mortality compared to those without depressive symptoms. This risk increased to 62% higher all-cause and 79% higher CVD for individuals with moderate to severe depressive symptoms. The association was also explored in relation to ischemic heart disease mortality, where individuals with moderate to severe depressive symptoms faced a 121% higher risk. Lifestyle factors explained around 11% to 16% of the link between depression and mortality. Notably, feelings of fatigue, poor appetite or overeating, and disinterest in activities were independently associated with both all-cause and CVD mortality. 

Authors noted that depressive symptoms were only measured at baseline, so there is no account for how depressive symptoms changed over time, which may have limited the results. 

Zhang Z, Jackson SD, Gillespie C, et al. Depressive symptoms and mortality among US adults. JAMA Netw Open. 2023;6(10). doi:10.1001/jamanetworkopen.2023.37011