Depressive symptoms and carotid artery intima-media thickness in police officers

  • John M. ViolantiEmail author
  • Luenda E. Charles
  • Ja K. Gu
  • Cecil M. Burchfiel
  • Michael E. Andrew
  • P. Nedra Joseph
  • Joan M. Dorn
Original Article



Police work is a stressful occupation. Depressive symptoms, which may occur as a result of exposure to stressors in police work, have been known to be associated with an increased risk of cardiovascular disease. This cross-sectional study investigated the association between depressive symptoms and carotid artery intima-media thickness (CIMT) among police officers.


CIMT was measured with B-mode carotid ultrasonography. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Analyses of variance and covariance were utilized to examine the mean values of common CIMT (CCA IMT) and maximum CIMT (MMXIMT) across quintiles of depressive symptoms.


Participants included 412 officers (mean age = 41 years). Hypertension status significantly modified the association between CES-D score and CIMT. The association between CES-D score and CCA IMT was statistically significant (adjusted P = 0.030) but only among officers without hypertension. The associations between CES-D score and MMXIMT were not significant among officers with or without hypertension. Our results also showed that among officers who reported poor sleep quality, mean levels of CCA IMT, and MMXIMT tended to increase as depressive symptoms increased.


Depressive symptoms may be therefore be independently associated with CIMT, yet masked by hypertension. Even though sleep quality did not significantly modify the main association, our results also suggest that poor sleep quality may act synergistically with depressive symptoms to increase CIMT. Future prospective work would help to clarify these associations.


Cardiovascular disease Depression Risk factors Police 



This work was supported by the National Institute for Occupational Safety and Health (NIOSH), contract no. 200-2003-01580. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • John M. Violanti
    • 1
    Email author
  • Luenda E. Charles
    • 2
  • Ja K. Gu
    • 2
  • Cecil M. Burchfiel
    • 2
  • Michael E. Andrew
    • 2
  • P. Nedra Joseph
    • 3
  • Joan M. Dorn
    • 4
  1. 1.Department of Social and Preventive Medicine, School of Public Health and Health ProfessionsUniversity at Buffalo, State University of New YorkBuffaloUSA
  2. 2.Biostatistics and Epidemiology Branch, Health Effects Laboratory DivisionNational Institute for Occupational Safety and Health, Centers for Disease Control and PreventionMorgantownUSA
  3. 3.The University of Chicago Comprehensive Cancer Center, Epidemiology and Research Recruitment CoreChicagoUSA
  4. 4.Department of Exercise and Nutrition Sciences, School of Public Health and Health ProfessionsState University of New York at BuffaloBuffaloUSA

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