1. Cardiovascular risk goes up as your mood goes down: Interaction of depression and socioeconomic status in determination of cardiovascular risk in the CONSTANCES cohort
- Author
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Hélène Vulser, Sébastien Czernichow, Jack Siemiatycki, Emmanuel Wiernik, Anna Ozguler, Nicolas Hoertel, Marie Zins, Hermann Nabi, Pierre Meneton, Cédric Lemogne, Jean-Philippe Empana, Marcel Goldberg, Frédéric Limosin, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Centre de Psychiatrie et Neurosciences (U894), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Département de Recherche en sciences sociales et humaines [Boulogne-Billancourt], Institut national du cancer [Boulogne] (INCA), Université Paris Descartes - Paris 5 (UPD5), INSERM UMS 011, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), IReSP (LEMOGNE-AAP16-PREV-13). Association Robert Debré pour la Recherche Médicale. Inserm, ANR-11-INBS-0002,CONSTANCES,La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance(2011), and European Project: 633666,H2020,H2020-PHC-2014-two-stage,LIFEPATH(2015)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Epidemiology ,[SDV]Life Sciences [q-bio] ,Population ,030204 cardiovascular system & hematology ,Risk Assessment ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,education ,Socioeconomic status ,Depression (differential diagnoses) ,Aged ,education.field_of_study ,Framingham Risk Score ,Depression ,business.industry ,Incidence ,Middle Aged ,Effect modifier ,Coronary heart disease ,Survival Rate ,Mood ,Risk factors ,Social Class ,Cardiovascular Diseases ,Cohort ,Female ,France ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,Follow-Up Studies ,Forecasting ,Demography - Abstract
International audience; BACKGROUND - Recent evidence suggests that the association of psychological variables with the risk of coronary heart disease (CHD) might depend upon socioeconomic status (SES). However, it is unclear whether the association between depressive symptoms and CHD risk might differ according to three SES indicators (education, occupational status and household monthly income). METHODS - Among 34,836 working participants of the French CONSTANCES cohort (16,221 men, mean age [SD]: 44.0 [10.4] years) without history of cardiovascular disease, depressive symptoms were assessed with the Center of Epidemiologic Studies Depression scale (CES-D). The Framingham risk equation calibrated to the French population estimated the participant's 10-year risk of CHD. Associations between depressive symptoms and CHD risk were estimated using linear regression models in SES strata. RESULTS - The estimated 10-year risk of CHD was 16.9% in men and 1.8% in women. In men, the increased CHD risk in those with (versus without) depressive symptoms was more pronounced as occupational status decreased, being 0.65% (−0.57; 1.88), 1.58% (0.50; 2.66) and 3.19% (1.30; 5.07) higher in individuals of high, medium and low occupational status, respectively (p for interaction: 0.01). In contrast, effect modification by education or household income was less evident, despite similar trends. In women, no effect modification was found whatever the SES indicator. CONCLUSIONS - Depressive symptoms and 10-year estimated CHD risk were more tightly linked in individuals of lower SES, at least in men. Occupational status was the SES indicator that displays the most obvious effect modification on this association.
- Published
- 2018