Cardiac risk factors in patients with diabetes mellitus and major depression
- 1 December 2004
- journal article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 19 (12), 1192-1199
- https://doi.org/10.1111/j.1525-1497.2004.30405.x
Abstract
OBJECTIVE: The prevalence of major depression is approximately 2-fold higher in patients with diabetes mellitus compared to medical controls. We explored the association of major depression with 8 cardiac risk factors in diabetic patients with and without evidence of cardiovascular disease (CVD). DESIGN: A mail survey questionnaire was administered to a population-based sample of 4,225 patients with diabetes to obtain data on depression status, diabetes self-care (diet, exercise, and smoking), diabetes history, and demographics. On the basis of automated data we measured diabetes complications, glycosylated hemoglobin, medical comorbidity, low-density lipid levels, triglyceride levels, diagnosis of hypertension, and evidence of microalbuminuria. Separate analyses were conducted for subgroups according to the presence or absence of CVD. SETTING: Nine primary care clinics of a nonprofit health maintenance organization. MAIN RESULTS: Patients with major depression and diabetes were 1.5- to 2-fold more likely to have 3 or more cardiovascular risk factors as patients with diabetes without depression (62.5% vs 38.4% in those without CVD, and 61.3% vs 45% in those with CVD). Patients with diabetes without CVD who met criteria for major depression were significantly more likely to be smokers, to have a body mass index (BMI) ≥ 30 kg/m2, to lead a more sedentary lifestyle, and to have HbA1c levels of >8.0% compared to nondepressed patients with diabetes without heart disease. Patients with major depression, diabetes, and evidence of heart disease were significantly more likely to have a BMI ≥30 kg/m2, a more sedentary lifestyle, and triglyceride levels >400 mg/dl than nondepressed diabetic patients with evidence of heart disease. CONCLUSIONS: Patients with major depression and diabetes with or without evidence of heart disease have a higher number of CVD risk factors. Interventions aimed at decreasing these risk factors may need to address treatment for major depression in order to be effective.Keywords
This publication has 47 references indexed in Scilit:
- Association of leisure-time physical activity on inflammation markers (C-reactive protein, white cell blood count, serum amyloid A, and fibrinogen) in healthy subjects (from the ATTICA study)The American Journal of Cardiology, 2003
- Management of Dyslipidemia in Adults With DiabetesDiabetes Care, 2003
- Depression as a predictor for coronary heart diseaseAmerican Journal of Preventive Medicine, 2002
- Depressive symptomatology and coronary heart disease in Type I diabetes mellitus: A study of possible mechanisms.Health Psychology, 2002
- The PHQ-9Journal of General Internal Medicine, 2001
- The summary of diabetes self-care activities measure: results from 7 studies and a revised scale.Diabetes Care, 2000
- Adherence to a Prophylactic Medication Regimen in Patients With Symptomatic Versus Asymptomatic Ischemic Heart DiseaseBehavioral Medicine, 1998
- Lifetime Prevalence of Major Depression and Its Effect on Treatment Outcome in Obese Type II Diabetic PatientsDiabetes Care, 1992
- Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluationClinical Psychology Review, 1988
- A general cardiovascular risk profile: The Framingham studyThe American Journal of Cardiology, 1976