HealthDay News — Depressive symptoms are associated with an increased risk for incident cardiovascular disease (CVD) and mortality in economically diverse settings, according to a study published online June 10 in JAMA Psychiatry.

Selina Rajan, from the London School of Hygiene & Tropical Medicine, and colleagues conducted a multicenter cohort study involving 370 urban and 314 rural communities from 21 economically diverse countries on five continents to examine associations between depressive symptoms and incident CVD and all-cause mortality.

The researchers found that at baseline, 11 percent of the 145,862 participants reported four or more depressive symptoms. In multivariable models, depression was associated with incident CVD, all-cause mortality, the combined CVD/mortality outcome, myocardial infarction, and noncardiovascular death (hazard ratios, 1.14, 1.17, 1.18, 1.23, and 1.21, respectively). There was a progressive increase noted in the risk for the combined outcome with the number of symptoms, with the highest risk for those with seven symptoms (hazard ratio, 1.24). In seven different geographical regions and in countries at all economic levels, the associations between having four or more depressive symptoms and the combined outcome were similar; stronger associations were seen in urban versus rural communities (hazard ratio, 1.23 versus 1.10) and for men versus women (hazard ratio, 1.27 versus 1.14).

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“Broader public policies should promote mental well-being and healthy behaviors as part of a comprehensive strategy to control noncommunicable diseases,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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