Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death

Circulation. Cardiovascular Quality and Outcomes
Carmela AlcántaraKarina W Davidson

Abstract

Depression and stress have each been found to be associated with poor prognosis in patients with coronary heart disease. A recently offered psychosocial perfect storm conceptual model hypothesizes amplified risk will occur in those with concurrent stress and depressive symptoms. We tested this hypothesis in a large sample of US adults with coronary heart disease. Participants included 4487 adults with coronary heart disease from the REasons for Geographic and Racial Differences in Stroke study, a prospective cohort study of 30,239 black and white adults. We conducted Cox proportional hazards regression with the composite outcome of myocardial infarction or death and adjustment for demographic, clinical, and behavioral factors. Overall, 6.1% reported concurrent high stress and high depressive symptoms at baseline. During a median 5.95 years of follow-up, 1337 events occurred. In the first 2.5 years of follow-up, participants with concurrent high stress and high depressive symptoms had increased risk for myocardial infarction or death (adjusted hazard ratio, 1.48 [95% confidence interval, 1.08-2.02]) relative to those with low stress and low depressive symptoms. Those with low stress and high depressive symptoms (hazard ratio, 0....Continue Reading

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Mar 16, 2016·Neural Plasticity·Vanja DuricLi-Lian Yuan
Apr 14, 2016·Journal of Epidemiology and Community Health·Guadalupe GómezUrania Dafni
Oct 21, 2015·Current Cardiology Reports·Jonathan GallagherFrank Doyle

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