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抑郁与心血管疾病的关联。

Association of Depression and Cardiovascular Disease.

机构信息

Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY.

Section of Cardiology, Baylor College of Medicine, Houston, Texas.

出版信息

Am J Med. 2023 Sep;136(9):881-895. doi: 10.1016/j.amjmed.2023.04.036. Epub 2023 May 27.

Abstract

BACKGROUND

Cardiovascular disease remains the leading worldwide cause of mortality. There has been increased awareness of the impact of psychological health on cardiovascular disease. In particular, major depression has been linked to increased all-cause mortality, development of cardiovascular disease, and worse outcomes in those with existing cardiovascular disease.

METHODS

We conducted a meta-analysis assessing the incidence of cardiovascular disease and cardiovascular disease outcomes among those with major depressive disorder.

RESULTS

Among 26 studies of 1,957,621 individuals, depression was associated with increased risk of incident stroke (hazard ratio [HR] 1.13; 95% confidence interval [CI], 1.00-1.28), myocardial infarction (HR 1.28; 95% CI, 1.14-1.45), congestive heart failure (HR 1.04; 95% CI, 1.00-1.09), or any cardiovascular disease (HR 1.16; 95% CI, 1.04-1.30). Depression was associated with increased risk of all-cause mortality (HR 1.43; 95% CI, 1.27-1.60), cardiovascular disease mortality (HR 1.44; 95% CI, 1.27-1.63), and congestive heart failure mortality (HR 3.20; 95% CI, 1.29-7.94).

CONCLUSION

Depression has a significant negative impact on development of cardiovascular disease and on cardiovascular disease outcomes. Further efforts to understand and mitigate these impacts are prudent.

摘要

背景

心血管疾病仍然是全球范围内导致死亡的主要原因。人们越来越意识到心理健康对心血管疾病的影响。特别是,重度抑郁症与全因死亡率增加、心血管疾病的发展以及已有心血管疾病患者的预后恶化有关。

方法

我们进行了一项荟萃分析,评估了患有重度抑郁症的患者发生心血管疾病和心血管疾病结局的情况。

结果

在对 1957621 名患者的 26 项研究中,抑郁与卒中(风险比 [HR] 1.13;95%置信区间 [CI],1.00-1.28)、心肌梗死(HR 1.28;95% CI,1.14-1.45)、充血性心力衰竭(HR 1.04;95% CI,1.00-1.09)或任何心血管疾病(HR 1.16;95% CI,1.04-1.30)的风险增加相关。抑郁与全因死亡率(HR 1.43;95% CI,1.27-1.60)、心血管疾病死亡率(HR 1.44;95% CI,1.27-1.63)和充血性心力衰竭死亡率(HR 3.20;95% CI,1.29-7.94)的风险增加相关。

结论

抑郁对心血管疾病的发生和心血管疾病结局有显著的负面影响。进一步努力理解和减轻这些影响是谨慎的。

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