Key Takeaways

From the Authors As published in the article
  1. Even infrequent depressive symptoms are associated with elevated cardiovascular risk in adults aged ≥50 years; assessing symptom frequency, rather than relying solely on diagnostic thresholds, can support early risk stratification in primary care.
  2. Patients who report both depressive symptoms and either obesity or current smoking have substantially higher odds of cardiovascular disease; this pattern underscores the importance of integrated screening for both mood and modifiable cardiometabolic risks.
  3. Incorporating brief and scalable depression screening tools into routine cardiovascular risk assessments may help clinicians identify high-risk patients and initiate timely, collaborative care interventions.
Extended Takeaways
  1. In adults aged ≥50 years, overall CVD prevalence was 8.5%, but patients reporting depressive symptoms had higher subtype prevalence than those without symptoms: CHD (10.8% vs 8.4%), angina (14.6% vs 11.7%), MI (15.4% vs 12.3%), and CHF (12.5% vs 9.1%) (all P <.001).
  2. The strongest symptom-frequency gradient was seen for CHD and angina, with CHD rising from 7.3% in the “not at all” group to 18.2% in the “nearly every day” group, and angina rising from 3.7% to 13.6%; all trend tests across frequency categories were statistically significant (P < .001).
  3. Depression in patients with established CVD may signal a more complex cardiovascular phenotype: among those with CHD, 68% of depressed individuals also reported angina compared to 57% of nondepressed participants (P < .001), and among CHF patients, 71% of depressed participants also reported a prior MI vs 62% without depression.
  4. Among participants with CVD, depressive symptoms were consistently associated with higher body weight burden, with median BMI reaching 30.8 kg/m2 in CHD, 30.5 kg/m2 in angina pectoris, 31.3 kg/m2 in CHF, and 30.7 kg/m2 in MI; all comparisons versus those without depressive symptoms were statistically significant (P <.001).
  5. The subgroup reporting “nearly every day” symptoms was small (n = 22), so clinicians should interpret the highest-frequency estimates cautiously even though the overall pattern across symptom categories remained directionally consistent.
  6. Women were more frequently represented among those reporting symptoms on several days (61.2%) and more than half the days (57.0%), whereas men predominated in the “nearly every day” group (68.2%), suggesting that symptom presentation and disclosure patterns may differ by sex in older adults.
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Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

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