When Blue-Collars Feel Blue

Abstract

M ajor depression and cardiovascular diseases are the leading causes of disability worldwide. 1 In addition, depressed individuals display an increased risk of cardiovascular diseases, especially coronary heart disease (CHD). 2,3 This association has been extensively studied and is not specific to major depression because it is also observed with self-reported depressive symptoms, henceforth referred to as depression.2 However, it remains debated whether the strength of this association depends on moderating factors, such as socioeconomic status (SES).Because depression and low SES are associated, 4 SES indicators are typically considered as potentially confounding the association between depression and cardiovascular diseases. Alternatively, depression has been proposed as a potential mediator of social inequalities in cardiovascular health. 5 However, a growing body of evidence suggests that the magnitude of the association between psychological variables and cardiovascular diseases may differ by SES (ie, a moderating factor).6-11 More specifically, this association may be stronger in individuals of low SES. For instance, in a prospective study by Redmond et al 6 among 24 443 individuals, perceived stress was associated with CHD in participants with low income only. Another prospective study by Lazzarino et al 7 showed that psychological distress and low SES were synergistic predictors Background-The association of psychological variables with cardiovascular health might depend on socioeconomic status.We examined the moderating effect of occupational grade on the association between depression and incident cardiac events among middle-aged workers from the GAZEL cohort. Methods and Results-A total of 10 541 participants (7855 men, mean age: 47.8±3.5 years) free of cardiovascular diseases completed the Center of Epidemiologic Studies Depression scale in 1993. Age, sex, and occupational grade (low, medium, and high) were obtained from company records. Classical cardiovascular risk factors were self-reported. All participants were followed-up for medically certified cardiac events from January 1994 to December 2014. Associations between baseline variables and incident cardiac events were estimated with hazard ratios and 95% confidence intervals computed in Cox regressions. After a median follow-up of 21 years, 592 (5.6%) participants had a cardiac event. There was a significant interaction between depression and occupational grade in both age-and sex-adjusted (P=0.008) and multiadjusted (P=0.009) models. This interaction was mainly explained by an association between depression and incident cardiac events that prevailed among participants of low occupational grade (

Is the number of ideal cardiovascular health metrics in midlife associated with lower risk of cancer? Evidence from 3 European prospective cohorts

“…Incident coronary heart disease and stroke were adjudicated following procedures previously reported. [19][20][21] All statistical tests had an α threshold of 0.05 unless stated otherwise. Analysis was conducted using SAS 9.4 (SAS Insti tute Inc.) and Stata 17.0 (StataCorp).…”