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The role of inflammatory markers in explaining the association between depression and cardiovascular hospitalisations

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Abstract

This study investigated whether inflammation may explain the relationship between depression and incident cardiovascular hospitalisations. Participants (55–85 years) completed baseline depression and physical assessment. Those without self-reported cardiovascular events were followed prospectively for hospital admissions for angina, myocardial infarction and cerebral infarction (median 937 days). Across 5140 person-years of risk (N = 1692), there were 47 incident cardiovascular hospitalisations (2.8 %). Controlling for age and gender, interleukin (IL)-6, C-reactive protein (CRP), body mass index (BMI) and waist-to-hip ratio were associated with future cardiovascular events. Mediation analysis showed that CRP accounted for 8.1 % and IL-6 10.9 % of the effect of depression on cardiovascular events, and including the indirect effect in the model substantially reduced the direct relationship between depression and cardiovascular hospitalisations. BMI and waist-to-hip ratio accounted for indirect effects of 7.7 and 10.4 %, respectively. Inflammatory markers partly explain the association between depression and cardiovascular events, although other shared factors also likely contribute.

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Acknowledgments

This research was conducted as part of the Hunter Community Study, University of Newcastle. We are grateful to the men and women of the Hunter region who provided the information recorded. We acknowledge funding from the University of Newcastle’s Strategic Initiatives Fund, Gladys M Brawn Senior Research Fellowship scheme, Vincent Fairfax Family Foundation and the John Hunter Charitable Trust. We also acknowledge the Hunter Medical Research Institute who provided media support during the initial recruitment of participants and Dr Anne Crotty, Prof. Rodney Scott and Prof. Chris Levi provided financial support towards freezing costs for the long-term storage of participant blood samples. Finally, we acknowledge the assistance of Dr Guy Hawkins in conducting the mediation analyses.

Conflict of interest

Sarah A. Hiles, Amanda L. Baker, Theo de Malmanche, Mark McEvoy, Michael Boyle and John Attia declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.

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Authors and Affiliations

  1. Faculty of Health, Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW, 2308, Australia

    Sarah A. Hiles & Amanda L. Baker

  2. Immunology, Hunter Area Pathology Service, John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia

    Theo de Malmanche

  3. Faculty of Health, Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW, 2308, Australia

    Mark McEvoy & John Attia

  4. Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia

    Mark McEvoy & John Attia

  5. Immunology and Infectious Diseases Unit, Medical and Interventional Service, John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia

    Michael Boyle

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  1. Sarah A. Hiles
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Hiles, S.A., Baker, A.L., de Malmanche, T. et al. The role of inflammatory markers in explaining the association between depression and cardiovascular hospitalisations. J Behav Med 38, 609–619 (2015). https://doi.org/10.1007/s10865-015-9637-2

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