Study data published in Annals of Medicine outline a potential association between arterial stiffness and non-melancholic depressive symptoms in men. In a cohort study of adults living in Finland, a relationship was observed between higher pulse wave velocity (PWV) and increased symptoms of depression among men. These results corroborate prior research which suggests that depression and cardiovascular health are interrelated.
To better understand the relationship between cardiovascular dysregulation and depression, investigators extracted data from the Helsinki Birth Cohort Study, an ongoing study of men and women born between 1934 and 1944 at hospitals in Helsinki, Finland. Members of the birth cohort were followed-up regularly since enrollment at birth. The present study used cross-sectional data on depressive symptoms and cardiac health obtained in 2017-2018.
Depressive symptoms were measured using the Beck Depression Inventory (BDI); a cut-off of ≥10 total points was used to determine the presence of depression. Carotid-femoral pulse wave velocity (cfPWV) and carotid-radial (crPWV) were measured to assess arterial stiffness.
Descriptive statistics were used to compare characteristics between patients with significant depressive symptoms (BDI ≥10) and patients without significant depressive symptoms (BDI <10). The relationships between depressive symptoms and PWV were assessed using a 2-way analysis of covariance, adjusted for age, medical comorbidities, mean arterial pressure, smoking status, and educational attainment. Analyses were stratified by sex due to known differences in PWV between sexes.
The study cohort comprised 683 Finnish adults, among whom 532 (78%) had a BDI <10 and 151 (22%) had a BDI ≥10. Of patients with depression, 122 were classified as having “non-melancholic” depressive symptoms and 29 were classified as having “melancholic” depressive symptoms. Individuals with depressive symptoms were more likely to be women (70% vs 51%) and had a slightly older mean age (77 vs 76 years) compared with individuals without depression (both P <.001). The group with depressive symptoms also had higher mean triglyceride concentrations (P =.018) and a greater number of medical comorbidities (P =.027).
Among women, no apparent relationship was observed between BDI and cfPWV, nor between BDI and crPWV. However, among men, BDI scores were substantially positively correlated with crPWV (P <.001). The relationship between crPWV and BDI was particularly pronounced among men with non-melancholic depression (P =.009). Men with non-melancholic depression had the highest mean crPWV values of any group. Depression type did not appear to influence crPWV or cfPWV values in women. In the total cohort, men had significantly higher mean crPWV values than women (P <.001).
Per these data, arterial stiffness appears to affect depression and depressive symptoms, particularly in men. However, cross-sectional study data cannot be used to assert causality. Further research is necessary to better understand the nature and directionality of the association between depression and PWV.
“A better understanding of the pathophysiology of the depressive subtypes may enable us to eventually develop more precise and efficient treatments for depression,” the investigators wrote. “By analyzing differences between the depressive subtypes and their relationships to physiological mechanisms, such as PWV, we may gain more insight into why these subtypes behave so differently.”
Eriksson MD, Eriksson JG, Kautiainen H, et al. Higher carotid-radial pulse wave velocity is associated with non-melancholic depressive symptoms in men – findings from Helsinki Birth Cohort Study. Ann Med. Published online March 26, 2021. doi: 10.1080/07853890.2021.1904277