Persistent cognitive depressive symptoms are associated with coronary artery calcification

OBJECTIVES: The association between depression and sub-clinical atherosclerosis remains unclear. By assessing depressive symptoms only at one point in time, most previous studies have failed to ascertain long-term exposure. We examined the association of long-term depressive symptoms assessed at three time points (over 10 yrs) with a marker of sub-clinical atherosclerosis. METHODS: Participants included 454 healthy, non-medicated men and women from the Whitehall II epidemiological cohort without known cardiovascular disease (CVD). Depressive symptoms were assessed at three time points (over 10 yrs) and coronary atherosclerosis was assessed at follow-up in terms of coronary artery calcification (CAC). RESULTS: 18.9% of the sample reported depressive symptoms at least once during follow-up. Participants that were persistently depressed had over a two-fold increased risk of detectable CAC (Agatston score > 0) (odds ratio [OR] = 2.56, 95% CI, 1.14–5.78) and high CAC (Agatston score ≥ 100) (OR = 2.36, 1.04–5.35) compared with never depressed after adjustment for age, sex, and a range of conventional cardiac risk factors. These associations were more robust in men. Participants who were depressed on only one occasion were not at elevated risk of CAC. CONCLUSIONS: Persistent cognitive symptoms of depression assessed over several time points, but not on a single occasion, are related to sub-clinical coronary atherosclerosis in men free of known CVD and diabetes.