U.S. veterans with depression had a 14% higher risk of heart failure, a new Vanderbilt University Medical Center-led study found, even after adjusting for traditional risk factors.
The study, "Depression and Heart Failure in U.S. Veterans," was published May 8 in the journal JAMA Network Open.
Corresponding author Evan Brittain, MD, MSCI, professor of Medicine, said the study suggests implications for patient care.
"Patients and clinicians have another reason to screen for and treat depression in order to prevent potential future heart failure," he said.
Brittain, who holds the Cardiology Division Directorship, noted the study is the largest of its kind, analyzing a sample of 3.4 million veterans from 2000 to 2015, who received care at Veterans Administration facilities. Participants were born between 1945 and 1965, met a medical home definition (had three outpatient visits within five years), and were free of heart failure at baseline. Participants were excluded if they were younger than 18, had unknown sex data, had death within one year of meeting the definition of medical home, or had received a heart transplant before or within one year of meeting that definition.
In addition to finding that patients with depression were 14% more likely to have heart failure, the study showed depressed veterans had a higher prevalence of chronic obstructive pulmonary disease (12.9% vs. 7.1%), smoking status (43.2% vs. 34.7%) and alcohol use disorder (35.4% vs. 11.3%.)
"Among adults without significant health problems, depression was associated with an even higher risk (58%) of new heart failure during follow-up," Brittain said.
The study concluded that further study is warranted to determine whether earlier diagnosis and treatment for depression can reduce the risk of heart failure.
"It is important to focus on assessment of depression treatment and its impact on heart failure or other cardiovascular diseases to further clarify this relationship and advise treating clinicians," Brittain said.
Other Vanderbilt authors of the paper were Jamie Plaff, MD; Svetlana Eden, PhD; Suman Kundu, DSc, MSc; Jonah Garry, MD; Robert Greevy, PhD; and Matthew Freiberg, MD, MSc.
The study was supported by the National Institutes of Health grant R01HL146588.
