JAHA：抑郁和高风险的外周动脉疾病相关联

近日，来自加利福尼亚大学等机构的科学家通过对1000名患心脏病的男性和女性进行调查研究，发现抑郁和高风险的外周动脉疾病（peripheral artery disease，PAD）相关联。

PAD是一种机体循环疾病，狭窄的动脉可以降低血液在四肢（通常在腿部和脚步）流动，最终导致患者机体疼痛、移动能力降低，情况严重会产生坏疽，不得不使用手术进行切除。

相关研究成果刊登在了7月26日的国际杂志《美国心脏协会杂志》Journal of the American Heart Association上。

领导此项研究的研究者Marlene Grenon是一名血管外科医生，他分析了来自1024名参与者的研究数据，研究数据来自对患冠状动脉疾病的参与者将近7年跟踪调查的数据。

研究者指出，我们发现这些患者从基准线上来看，其抑郁症和PAD有一定关系，而且研究者还发现，在七年的跟踪调查过程中，抑郁症病人更易于发展为PAD。

这些研究发现揭示了抑郁症和外周动脉疾病之间的密切关系，同时也强调了医疗手段必须改进以应对当前的疾病出现。

编译自：Depressed patients at risk of developing peripheral artery disease

doi:10.1161/​JAHA.112.002667
PMC:
PMID:

Association Between Depression and Peripheral Artery Disease: Insights From the Heart and Soul Study

S Marlene Grenon, MDCM, MMSc; Jade Hiramoto, MD; Kim G. Smolderen, PhD; Eric Vittinghoff, PhD; Mary A. Whooley, MD; Beth E. Cohen, MD, MAS

Background Depression is known to increase the risk of coronary artery disease, but few studies have evaluated the association between depression and peripheral artery disease (PAD). We examined the association of depression with PAD and evaluated potential mediators of this association. Methods and Results We used data from the Heart and Soul Study, a prospective cohort of 1024 men and women with coronary artery disease recruited in 2000–2002 and followed for a mean of 7.2±2.6 years. Depressive symptoms were assessed with the validated 9-item Patient Health Questionnaire. Prevalent PAD at baseline was determined by self-report. Prospective PAD events were adjudicated on the basis of review of medical records. We used logistic regression and Cox proportional-hazards models to estimate the independent associations of depressive symptoms with prevalent PAD and subsequent PAD events. At baseline, 199 patients (19%) had depressive symptoms (Patient Health Questionnaire ≥10). Prevalent PAD was reported by 12% of patients with depression and 7% of those without depression (base model adjusted for age and sex: odds ratio 1.79, 95% confidence interval 1.06–3.04, P=0.03; full model adjusted for comorbidities, medications, PAD risk factors, inflammation, and health behaviors: odds ratio 1.59, 95% confidence interval 0.90–2.83, P=0.11). During follow-up, PAD events occurred in 7% of patients with depression and 5% of those without depression (base model adjusted for age and sex: hazard ratio 2.09, 95% confidence interval 1.09–4.00, P=0.03; full model adjusted for comorbidities, medications, PAD risk factors, inflammation, and health behaviors: hazard ratio 1.33, 95% confidence interval 0.65–2.71, P=0.44). Factors explaining >5% of the association between depression and incident PAD events included race/ethnicity, diabetes, congestive heart failure, high-density lipoprotein, triglyceride levels, serum creatinine, inflammation, smoking, and levels of physical activity. Conclusions Depressive symptoms were associated with a greater risk of PAD. Because the association was explained partly by modifiable risk factors, our findings suggest that more aggressive treatment of these risk factors could reduce the excess risk of PAD associated with depression.