Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans: Veterans Aging Cohort Study.
White,J.R. Chang,C.C. So-Amah,K.A. Stewart,J.C. Gupta,S.K. Butt,A.A. Gibert,C.L. Rimland,D. Rodriguez-Barradas,M.C. Leaf,D.A.
White,J.R.
Chang,C.C.
So-Amah,K.A.
Stewart,J.C.
Gupta,S.K.
Butt,A.A.
Gibert,C.L.
Rimland,D.
Rodriguez-Barradas,M.C.
Leaf,D.A.
Abstract
Background Both HIV and depression are associated with increased heart failure (HF) risk. Depression, a common comorbidity, may further increase the risk of HF among adults with HIV infection (HIV+). We assessed the association between HIV, depression, and incident HF. Methods and Results Veterans Aging Cohort Study (VACS) participants free from cardiovascular disease at baseline (n=81 427: 26 908 HIV+, 54 519 without HIV [HIV−]) were categorized into 4 groups: HIV− without major depressive disorder (MDD) [reference], HIV− with MDD, HIV+ without MDD, and HIV+ with MDD. International Classification of Diseases, Ninth Revision codes from medical records were used to determine MDD and the primary outcome, HF. After 5.8 years of follow-up, HF rates per 1000 person-years were highest among HIV+ participants with MDD (9.32; 95% confidence interval [CI], 8.20–10.6). In Cox proportional hazards models, HIV+ participants with MDD had a significantly higher risk of HF (adjusted hazard ratio, 1.68; 95% CI, 1.45–1.95) compared with HIV− participants without MDD. MDD was associated with HF in separate fully adjusted models for HIV− and HIV+ participants (adjusted hazard ratio, 1.21; 95% CI, 1.06–1.37; and adjusted hazard ratio, 1.29; 95% CI, 1.11–1.51, respectively). Among those with MDD, baseline antidepressant use was associated with lower risk of incident HF events (adjusted hazard ratio, 0.76; 95% CI, 0.58–0.99). Conclusions Our study is the first to suggest that MDD is an independent risk factor for HF in HIV+ adults. These results reinforce the importance of identifying and managing MDD among HIV+ patients. Future studies must clarify mechanisms linking HIV, MDD, antidepressants, and HF and identify interventions to reduce HF morbidity and mortality in those with both HIV and MDD. Keywords: depression, epidemiology, heart failure, HIV
Description
Date
2015
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Volume Title
Publisher
Research Projects
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Keywords
SDG 3 - Good Health and Well-being
Citation
White, J R, Chang, C C, So-Amah, K A, Stewart, J C, Gupta, S K, Butt, A A, Gibert, C L, Rimland, D, Rodriguez-Barradas, M C, Leaf, D A, Bedimo, R J, Gottdiener, J S, Kop, W J, Gottlieb, S S, Budoff, M J, Khambaty, T, Tindle, H A, Justice, A C & Freiberg, M S 2015, 'Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans : Veterans Aging Cohort Study.', Circulation, vol. 132, no. 17, pp. 1630-1638. https://doi.org/10.1161/CIRCULATIONAHA.114.014443