New Study Ties Cardiovascular Health to Depressive Symptoms

Dr Thomas van Sloten, MD
Dr Thomas van Sloten, MD

Increasing connections between physical health and depressive symptoms continue to be found in the psychiatric world, making the distinction between mind and body that much more blurry.

In this Q&A, Thomas van Sloten, MD, Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, discusses the results of his latest study “Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms,” recently published in JAMA Psychiatry. Dr van Sloten and his fellow researchers found that cardiovascular health could indicate the risk of depressive symptoms and what that could mean for clinicians in day-to-day treatment.

This interview has been edited for clarity.

Evi Arthur, Associate Digital Editor, Psych Congress Network (PCN)What led you and your colleagues to investigate the connection between cardiovascular health and depressive symptoms?

    Dr Thomas van Sloten, MD: We focused on older individuals. Major depression and clinically relevant depressive symptoms are common among older individuals, with an estimated prevalence of 2% and 10% to 15%, respectively. Importantly, they are associated with lower quality of life and 1.5- to 2-fold higher mortality. However, current antidepressant medications are not sufficiently effective in older patients. A focus on prevention is, therefore, key to reducing the burden of late-life depression. Vascular risk factors are increasingly recognized as potential contributors to the development of late-life depression and, thus, as potential targets for early preventive therapies

    PCN: Please briefly describe the study method and participants.  

    Dr van Sloten: We included 6980 individuals from the GAZEL cohort study, a prospective community-based cohort in France. Of these individuals1671 (23.9%) were women, and the mean age was 53.3 years. Cardiovascular health examinations occurred in 1990 and 1997, and assessment of depressive symptoms occurred in 1997 and every 3 years thereafter until 2015. During a follow-up spanning 19 years after 1997, 1858 individuals (26.5%) had incident depressive symptoms. 

    PCN: Please briefly describe the most significant finding(s).  

    Dr van Sloten: Higher baseline cardiovascular health in 1997 and improvement in cardiovascular health over 7 years were each associated with a lower risk of depressive symptoms. Also, better cardiovascular health was associated with a lower risk of unfavorable depressive symptoms trajectories. 

    PCN: Were any outcomes different than you expected?  

    Dr van Sloten: We did not anticipate that the results on change in cardiovascular health were so consistent with the results on baseline cardiovascular health. Earlier studies on change in cardiovascular health with various other outcomes, including incident dementia, showed less strong effects. The fact that all results showed a positive effect of better cardiovascular health on the risk of depressive symptoms provides strong evidence for the validity of our findings. 

    PCN: What practical applications of your findings are there for clinicians treating patients with depression? 

    Dr van Sloten: This study focuses mainly on the prevention of depression. In daily practice, clinicians could use these results to stimulate individuals to improve their cardiovascular health. This may not only prevent the development of cardiovascular disease, but also depression. 

    PCN: Are you conducting any more research in this area, and what other studies do you feel are needed?  

    Dr van Sloten: The important next step is to better understand the mechanisms underlying the association between better cardiovascular health and lower risk of depression. Multiple factors are likely involved, amongst others low-grade inflammation and microvascular dysfunction. In our research, we are currently investigating those mechanisms. 

    PCN: Any final thoughts pertaining to this research? 

    Dr van Sloten: Prevention of late-life depression is key to improving the health-related quality of life among older individuals. I am convinced that for effective prevention, it is crucial to identify mechanisms that can be targeted at an early disease stage. 

    Thomas van Sloten, MD, is a clinical scientist at the Department of Vascular Medicine of the University Medical Centre Utrecht, the Netherlands. The focus of his research is the epidemiological study of the role of vascular dysfunction in the development of brain diseases that are common among older individuals, including stroke, dementia, and depression.

    Van Sloten TT, Valentin E, Climie RE, et al. Association of cardiovascular health with risk of clinically relevant depressive symptoms. JAMA Psych. Published online February 15, 2023. doi:10.1001/jamapsychiatry.2022.5056.