Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans veterans aging cohort study Academic Article Article uri icon

Overview

MeSH Major

  • Arcobacter
  • Bacteremia
  • Gram-Negative Bacterial Infections
  • Immunocompromised Host

abstract

  • © 2015 American Heart Association, Inc. 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.

publication date

  • October 27, 2015

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1161/CIRCULATIONAHA.114.014443

PubMed ID

  • 26358261

Additional Document Info

start page

  • 1630

end page

  • 1638

volume

  • 132

number

  • 17