Abdominal aortic aneurysm risk linked to depressive symptoms

Takeaway

• The risk for incident abdominal aortic aneurysm (AAA) is higher in individuals with symptoms of depression than those without depressive symptoms.

Why this matters

• Assessment of depressive symptoms in the risk evaluation of development of AAA could potentially be important when screening subgroups at increased risk of the disease.

Study design

• Study of 59,136 participants (aged, 50-106 years; 52.4% women; median follow-up period, 13 years) with no prior diagnosis of AAA.
• Depressive symptoms assessed using the depression subscale of the Hospital Anxiety and Depression Scale (HADS).
• Outcome: diagnosis of AAA.
• Funding: Department of Circulation and Medical Imaging at the Norwegian University of Science and Technology (NTNU).

Key results

• A total of 6401 individuals (12.3%) reported depressive symptoms (HADS-D ≥8).
• During the follow-up period, 742 incident cases of AAA (201 women) were reported.
• Estimated proportion of individuals diagnosed with AAA was higher among those with depressive symptoms (log-rank test, P<.001).
• People with HADS-D ≥8 vs those with HADS-D<8 were older (median 57.8 years vs 52.3 years) and a significant higher proportion of them were:
  • smokers (34% vs 28.9%; HR, 8.72; 95% CI, 6.56-11.61; P<.001) and
  • reported history of coronary heart disease (12.3% vs 6.9%; HR, 2.39; 95% CI, 2.00-2.85; P<.001) and hypertension (54.4% vs 49.0%; HR, 1.35; 95% CI, 1.12-1.62; P=.002).
• Incident AAA was >2.5 times higher among men than women (HR, 2.64; 95% CI, 2.18-3.20; P<.001).
• Individuals with HADS-D ≥8 vs those with HADS-D<8 had a 31% higher risk for incident AAA (HR, 1.32; 95% CI, 1.08-1.61; P=.007).     

Limitation

• Risk of bias.