Research published in The Journal of Pediatrics indicated no significant relationship between depression or anxiety symptomatology and cardiovascular disease (CVD) risk after adjusting for body fat percentage.

The cross-sectional study cohort consisted of 202 participants (52% boys) aged 8 to 18 years (mean 12.7 years) with a wide range of body mass index values from normal weight to severe obesity. Researchers assessed anxiety and depression symptoms in participants using the Screen for Child Anxiety Related Disorders and Center for Epidemiological Studies Depression Scale for Children. CVD risk measures included blood pressure, fasting lipid level, body fat percentage, and a metabolic syndrome cluster score.

Among those who had complete or imputed scores on the self-reported anxiety scale, 26% scored at or above the threshold suggestive of anxiety. Among those who reported depression symptoms, 23% had scores at or above the depression threshold. After controlling for Tanner stage of pubertal development, sex, and race, no significant relationships were observed between anxiety symptomatology and measures of CVD risk (P >.05). In this first adjusted model, depression symptoms were associated with high-density lipoprotein cholesterol (P =.001), triglycerides (P =.026), and the metabolic syndrome cluster score (P =.005); however, after controlling for body fat percentage, these relationships were no longer statistically significant (P >.05). The only relationship that remained significant across model adjustments was an increase in carotid artery cross-sectional compliance and anxiety symptomatology (P =.039). Even after stratifying analyses by age, no appreciable relationships were clarified.

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Researchers noted that the cross-sectional study design and lack of follow-up data limit the generalizability of these study results. The potential plasticity of the cardiovascular system during childhood may explain the lack of significant relationship between depression and anxiety symptomatology and CVD risk in this study population. Longitudinal studies are required to elucidate the potential relationship between these factors over time.  


Gross AC, Kaizer AM, Ryder JR, et al. Relationships of anxiety and depression with cardiovascular health in youth with normal weight to severe obesity [published online May 10, 2018]. J Pediatr. doi:10.1016/j.jpeds.2018.03.059