Role of depressive symptoms in accelerating cardiovascular diseases progression in cardiovascular-kidney-metabolic syndrome stages 0–3: A nationwide prospective cohort study

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-07-20 DOI:10.1016/j.genhosppsych.2025.07.013

Cui Ma , De-Feng Zhao , Lu Zhai , Rong-Rui Huo , Yu-Hua Liu

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引用次数: 0

Abstract

Objective

To examine the association of depressive symptoms with cardiovascular disease (CVD) risk in middle-aged and older adults with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3 and to assess whether this association varies by CKM syndrome stages. Also, interactions of depressive symptoms with CKM syndrome stages in relation to CVD risk were evaluated.

Methods

This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). Incident CVD events were identified based on self-reported physician-diagnosed (Participants were asked whether they had ever been diagnosed with disease by a physician). Cox proportional hazards regression models were used to estimate the association between depressive symptoms and CVD risk with interaction analyses across CKM syndrome stages.

Results

Among 3440 participants, 1833 (53.3 %) were women. Over the 7-year follow-up, 696 (20.2 %) developed CVD. After full adjustment, elevated depressive symptoms were associated with a 27.0 % higher CVD risk (HR, 1.27; 95 % CI, 1.07–1.50). Of the 10 individual depressive symptoms, only restless sleep (HR, 1.23; 95 % CI, 1.04–1.44), loneliness (HR, 1.26; 95 % CI, 1.05–1.52), and bothered by little things (HR, 1.21; 95 % CI, 1.01–1.45) were significantly associated with incident CVD. Moreover, depressive symptoms and CKM syndrome stages exhibited both multiplicative and additive interactions. Notably, in CKM syndrome stage 3, depressive symptoms were associated with a 36.0 % higher CVD risk (HR, 1.36; 95 % CI, 1.09–1.70).

Conclusions

Elevated depressive symptoms are associated with increased CVD risk in middle-aged and older adults with CKM syndrome stages 0–3, with a synergistic effect observed as CKM syndrome progresses. Highlighting the integration of mental health assessments into CKM risk stratification may enhance early intervention strategies and reduce CVD burden.

查看原文本刊更多论文

抑郁症状在心血管-肾-代谢综合征0-3期加速心血管疾病进展中的作用：一项全国前瞻性队列研究

目的探讨心血管-肾-代谢综合征（CKM） 0-3期中老年患者抑郁症状与心血管疾病（CVD）风险的相关性，并评估这种相关性是否因CKM综合征分期而异。此外，还评估了抑郁症状与CKM综合征阶段与CVD风险相关的相互作用。方法分析中国健康与退休纵向研究（CHARLS）的数据。心血管疾病事件是根据自我报告的医生诊断来确定的（参与者被问及他们是否曾经被医生诊断出患有疾病）。Cox比例风险回归模型用于评估抑郁症状与CVD风险之间的关联，并对CKM综合征各阶段的相互作用进行分析。结果3440例患者中，女性1833例（53.3%）。在7年的随访中，696例（20.2%）发生心血管疾病。完全调整后，抑郁症状升高与心血管疾病风险增加27.0%相关(HR, 1.27；95% ci, 1.07-1.50)。在10个个体抑郁症状中，只有躁动睡眠(HR, 1.23；95% CI, 1.04-1.44)，孤独(HR, 1.26；95% CI, 1.05-1.52)，被小事困扰(HR, 1.21；95% CI, 1.01-1.45)与CVD事件显著相关。此外，抑郁症状和CKM综合征阶段表现出乘法和加法的相互作用。值得注意的是，在CKM综合征第3期，抑郁症状与心血管疾病风险增加36.0%相关(HR, 1.36；95% ci, 1.09-1.70)。结论中老年CKM综合征0-3期患者抑郁症状加重与CVD风险增加相关，且随CKM综合征进展出现协同效应。强调将心理健康评估纳入CKM风险分层可以加强早期干预策略并减轻CVD负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.