Global Psychological Distress and Risk of Atrial Fibrillation Among Women: The Women's Health Study

Abstract

BACKGROUND: Symptoms of psychological distress and depression have been associated with risk of ventricular arrhythmias and sudden cardiac death. Their relationship with atrial arrhythmias, however, is less well studied.METHODS AND RESULTS: We sought to assess the long-term relations between psychological distress and risk of atrial fibrillation (AF) in the Women's Health Study of female health professionals. We measured psychological symptoms with the Mental Health Inventory-5. Incident AF was assessed annually and verified through medical records. Among 30 746 women without history of cardiovascular disease or AF, 771 cases of AF occurred during a median follow-up of 125 months (interquartile range, 117-130 months). Global psychological distress was not associated with AF risk in age-stratified (P=0.61 for linear trend) or multivariable proportional-hazards models that included antidepressant use (P=0.34). A proxy measure for depression, consisting of Mental Health Inventory-5 score <53, antidepressant use, or both, was also not associated with AF risk in multivariable models (hazard ratio=0.99; 95% confidence interval, 0.78-1.25; P=0.93). In post hoc analyses of individual symptoms from the Mental Health Inventory-5, positive affect, "feeling happy some/a good bit of the time," was associated with reduced risk of AF (hazard ratio=0.69; 95% confidence interval, 0.49-0.99; P=0.04); other depressive and anxious symptoms were not.CONCLUSIONS: In this prospective study of women without known cardiovascular disease, global psychological distress and specific depressive symptoms were unrelated to AF risk. (J Am Heart Assoc. 2012;1:e001107 doi: 10.1161/JAHA.112.001107.).