TY - JOUR T1 - Does the association between depressive symptoms and cardiovascular mortality risk vary by race? Evidence from the Health and Retirement Study. JF - Ethn Dis Y1 - 2013 A1 - Benjamin D Capistrant A1 - Paola Gilsanz A1 - J Robin Moon A1 - Anna Kosheleva A1 - Kristen K Patton A1 - M. Maria Glymour KW - Aged KW - Black or African American KW - Cardiovascular Diseases KW - depression KW - Female KW - Humans KW - Male KW - Middle Aged KW - Proportional Hazards Models KW - Risk Assessment KW - Risk Factors KW - White People AB -

OBJECTIVE: To test whether the association between depressive symptoms and cardiovascular disease (CVD) mortality is stronger among Blacks than Whites.

DESIGN, SETTING AND PARTICIPANTS: 2,638 Black and 15,132 White participants from a prospective, observational study of community-dwelling Health and Retirement Study participants (a nationally representative sample of U.S. adults aged > or = 50). Average follow-up was 9.2 years.

OUTCOME MEASURE: Cause of death (per ICD codes) and month of death were identified from National Death Index linkages.

METHODS: The associations between elevated depressive symptoms and mortality from stroke, ischemic heart disease (IHD), or total CVD were assessed using Cox proportional hazards models to estimate adjusted hazard ratios (HRs). We used interaction terms for race by depressive symptoms to assess effect modification (multiplicative scale).

RESULTS: For both Whites and Blacks, depressive symptoms were associated with a significantly elevated hazard of total CVD mortality (Whites: HR=1.46; 95% CI: 1.33, 1.61; Blacks: HR=1.42, 95% CI: 1.10, 1.83). Adjusting for health and socioeconomic covariates, Whites with elevated depressive symptoms had a 13% excess hazard of CVD mortality (HR=1.13, 95% CI: 1.03, 1.25) compared to Whites without elevated depressive symptoms. The HR in Blacks was similar, although the confidence interval included the null (HR=1.12, 95% CI: .86, 1.46). The hazard associated with elevated depressive symptoms did not differ significantly by race (P>.15 for all comparisons). Patterns were similar in analyses restricted to respondents age > or =65.

CONCLUSION: Clinicians should consider the depressive state of either Black or White patients as a potential CVD mortality risk factor.

PB - 23 VL - 23 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23530295?dopt=Abstract U2 - PMC3616329 U4 - cardiovascular disease/Racial Differences/Depressive Disorder/Depression in old age/Mortality/African Americans/Proportional Hazards Models/risk assessment/risk Factors ER -