Depression and markers of arteriosclerosis: Cross-sectional analyses of the baseline examination of the BiDirect cohort study

Abstract

The prospective BiDirect study was set up to uncover the potential bidirectional links between depression and arteriosclerosis, with a focus on markers of early and subclinical arteriosclerosis. The BiDirect cohort is composed of three different samples: a subsample of patients with clinically manifest depression, a cohort of patients after an acute cardiovascular event, and a reference group that was drawn from the general population. All study participants underwent interviews, anthropometric measurements, and measurements of blood pressure, ankle-brachial index (ABI), pulse wave velocity (PWV), augmentation index, body impedance, and carotid intima-media thickness (IMT). Composite, unweighted scores were created as summary measures to assess the burden of subclinical arteriosclerosis in the different subsamples. The BiDirect baseline examination lasted from May 2010 to June 2013. Cross-sectional analyses of the baseline examination revealed signifi-cantly increased measures for body and fat mass, but lower levels of blood pressure in the depressive cohort. Single indicators of subclinical arteriosclerosis (ankle-brachial index (ABI), pulse wave velocity (PWV), intima-media thickness (IMT), and carotid plaque) as well as an unweighted composite score of these markers showed no differences between the depression and the reference cohort at baseline. However, when the presence of adverse lifestyle factors, such as smoking and overweight, was additionally taken into consideration, the depressive cohort showed a raised propensity to arteriosclerosis, especially among those younger than 50 years. Expectedly, the cohort with clinically manifest cardiovascular disease showed consistently the highest values and scores of arteriosclerosis.