Fig. 1Flow diagram of the study population.
Table 1Descriptive characteristics of the study population
Characteristic |
Men |
Women |
No depression |
Depression |
P value |
No depression |
Depression |
P value |
No. of people |
31,590 |
772 |
|
37,857 |
2,016 |
|
Age, yr |
58.0±8.4 |
60.3±9.2 |
<0.001 |
60.4±8.2 |
62.0±8.4 |
<0.001 |
Household income, quartiles |
|
|
0.051 |
|
|
0.001 |
1st (highest) |
12,893 (40.8) |
302 (39.1) |
11,414 (30.2) |
678 (33.6) |
2nd |
9,365 (29.7) |
207 (26.8) |
10,995 (29.0) |
597 (29.6) |
3rd |
5,727 (18.1) |
161 (20.9) |
8,572 (22.6) |
413 (20.5) |
4th (lowest) |
3,605 (11.4) |
102 (13.2) |
6,876 (18.2) |
328 (16.3) |
Smoking status |
|
|
0.394 |
|
|
0.368 |
Never smoker |
12,943 (41.0) |
326 (42.2) |
36,916 (97.5) |
1,956 (97.0) |
Past smoker |
9,851 (31.2) |
223 (28.9) |
201 (0.8) |
18 (0.9) |
Current smoker |
8,796 (27.8) |
223 (28.9) |
640 (1.7) |
42 (2.1) |
Physical activity, time/wk |
|
|
0.228 |
|
|
0.872 |
None |
13,196 (41.8) |
328 (42.5) |
21,187 (56.0) |
1,134 (56.3) |
1–2 |
9,375 (29.7) |
226 (29.3) |
7,645 (20.2) |
408 (20.2) |
3–4 |
5,247 (16.6) |
115 (14.9) |
4,743 (12.5) |
258 (12.8) |
5–6 |
1,990 (6.3) |
46 (6.0) |
2,050 (5.4) |
98 (4.9) |
7 |
1,782 (5.6) |
57 (7.4) |
2,232 (5.9) |
118 (5.9) |
Alcohol consumption, time/wk |
|
|
<0.001 |
|
|
0.218 |
None |
11,743 (37.2) |
354 (45.9) |
31,943 (84.4) |
1,737 (86.2) |
<1 |
6,701 (21.2) |
175 (22.7) |
4,094 (10.8) |
201 (10.0) |
1–2 |
6,668 (21.1) |
126 (16.3) |
1,159 (3.1) |
49 (2.4) |
3–4 |
4,374 (13.9) |
73 (9.5) |
449 (1.2) |
21 (1.0) |
≥5 |
2,104 (6.7) |
44 (5.7) |
212 (0.6) |
8 (0.4) |
Body mass index, kg/m2
|
24.8±2.7 |
24.2±2.7 |
<0.001 |
24.6±3.1 |
24.5±3.1 |
0.192 |
Systolic blood pressure, mm Hg |
127.8±14.5 |
126.4±14.0 |
0.009 |
126.3±15.8 |
125.2±15.5 |
0.003 |
Fasting serum glucose, mg/dL |
107.9±31.8 |
103.7±23.6 |
<0.001 |
101.3±26.2 |
101.9±24.6 |
0.293 |
Total cholesterol, mg/dL |
200.0±45.8 |
197.6±45.1 |
0.141 |
210.0±45.7 |
204.5±45.3 |
<0.001 |
Statin MPR |
0.4±0.4 |
0.4±0.4 |
0.840 |
0.4±0.3 |
0.5±0.4 |
<0.001 |
Charlson comorbidity index |
|
|
<0.001 |
|
|
<0.001 |
≤1 |
14,167 (44.9) |
212 (27.5) |
13,901 (36.7) |
396 (19.6) |
2 |
7,537 (23.9) |
167 (21.6) |
9,507 (25.1) |
465 (23.1) |
3 |
4,899 (15.5) |
150 (19.4) |
6,943 (18.3) |
420 (20.8) |
≥4 |
4,987 (15.8) |
243 (31.5) |
7,506 (19.8) |
735 (36.5) |
Table 2Hazard ratios for cardiovascular disease according to depression within 3 years before diagnosis for dyslipidemia
Variable |
Total |
Men |
Women |
No depression |
Depression |
No depression |
Depression |
No depression |
Depression |
Cardiovascular disease |
|
|
|
|
|
|
Events |
4,891 |
239 |
2,481 |
78 |
2,410 |
161 |
Person-years |
362,340 |
13,065 |
164,155 |
3,636 |
198,185 |
9,428 |
aHR (95% CI)a
|
1.00 (reference) |
1.24 (1.09–1.41) |
1.00 (reference) |
1.18 (0.94–1.49) |
1.00 (reference) |
1.26 (1.07–1.48) |
Coronary heart disease |
|
|
|
|
|
|
Events |
2,655 |
121 |
1,477 |
43 |
1,178 |
78 |
Person-years |
362,340 |
13,065 |
164,155 |
3,636 |
198,185 |
9,428 |
aHR (95% CI)a
|
1.00 (reference) |
1.20 (1.00–1.44) |
1.00 (reference) |
1.10 (0.81–1.49) |
1.00 (reference) |
1.26 (1.00–1.58) |
Stroke |
|
|
|
|
|
|
Events |
2,302 |
120 |
1,043 |
36 |
1,259 |
84 |
Person-years |
362,340 |
13,065 |
164,155 |
3,636 |
198,185 |
9,428 |
aHR (95% CI)a
|
1.00 (reference) |
1.27 (1.06–1.53) |
1.00 (reference) |
1.30 (0.93–1.82) |
1.00 (reference) |
1.24 (1.00–1.55) |
Table 3Stratified analysis on the association of depression within 3 years before dyslipidemia diagnosis on cardiovascular disease according to subgroups of statin medication compliance
Variable |
Adjusted hazard ratio (95% confidence interval)a
|
Cardiovascular disease |
Coronary heart disease |
Stroke |
No depression |
Depression |
No depression |
Depression |
No depression |
Depression |
Total |
|
|
|
|
|
|
MPR ≥0.8 |
1.00 (reference) |
1.42 (1.06–1.90) |
1.00 (reference) |
1.40 (0.94–2.08) |
1.00 (reference) |
1.35 (0.89–2.04) |
MPR 0.5–0.7 |
1.00 (reference) |
1.17 (0.91–1.52) |
1.00 (reference) |
1.12 (0.79–1.59) |
1.00 (reference) |
1.10 (0.76–1.59) |
MPR <0.5 |
1.00 (reference) |
1.25 (1.05–1.50) |
1.00 (reference) |
1.14 (0.88–1.47) |
1.00 (reference) |
1.29 (1.01–1.65) |
Men |
|
|
|
|
|
|
MPR ≥0.8 |
1.00 (reference) |
1.77 (1.14–2.74) |
1.00 (reference) |
1.71 (0.98–3.00) |
1.00 (reference) |
1.89 (1.00–3.60) |
MPR 0.5–0.7 |
1.00 (reference) |
1.15 (0.74–1.81) |
1.00 (reference) |
0.89 (0.48–1.68) |
1.00 (reference) |
1.44 (0.78–2.65) |
MPR <0.5 |
1.00 (reference) |
1.03 (0.73–1.46) |
1.00 (reference) |
0.93 (0.59–1.46) |
1.00 (reference) |
1.19 (0.73–1.93) |
Women |
|
|
|
|
|
|
MPR ≥0.8 |
1.00 (reference) |
1.22 (0.82–1.80) |
1.00 (reference) |
1.15 (0.65–2.03) |
1.00 (reference) |
1.11 (0.65–1.92) |
MPR 0.5–0.7 |
1.00 (reference) |
1.19 (0.87–1.63) |
1.00 (reference) |
1.28 (0.84–1.96) |
1.00 (reference) |
0.95 (0.60–1.52) |
MPR <0.5 |
1.00 (reference) |
1.33 (1.08–1.65) |
1.00 (reference) |
1.24 (0.91–1.69) |
1.00 (reference) |
1.32 (0.99–1.75) |
Table 4Stratified analysis on the association of depression within 3 years before dyslipidemia diagnosis on cardiovascular disease according to subgroups of smoking, physical activity, alcohol consumption, and body mass index
Variable |
Adjusted hazard ratio (95% confidence interval)a
|
Cardiovascular disease |
Coronary heart disease |
Stroke |
No depression |
Depression |
No depression |
Depression |
No depression |
Depression |
Smoking |
|
|
|
|
|
|
Never smoker |
1.00 (reference) |
1.28 (1.10–1.48) |
1.00 (reference) |
1.26 (1.02–1.55) |
1.00 (reference) |
1.27 (1.04–1.56) |
Past or current smoker |
1.00 (reference) |
1.11 (0.82–1.51) |
1.00 (reference) |
1.04 (0.69–1.56) |
1.00 (reference) |
1.26 (0.81–1.95) |
Physical activity |
|
|
|
|
|
|
No |
1.00 (reference) |
1.23 (1.04–1.46) |
1.00 (reference) |
1.24 (0.97–1.57) |
1.00 (reference) |
1.23 (0.97–1.57) |
Yes |
1.00 (reference) |
1.26 (1.03–1.54) |
1.00 (reference) |
1.16 (0.88–1.54) |
1.00 (reference) |
1.33 (1.00–1.78) |
Alcohol consumption |
|
|
|
|
|
|
No |
1.00 (reference) |
1.23 (1.06–1.42) |
1.00 (reference) |
1.18 (0.96–1.46) |
1.00 (reference) |
1.26 (1.03–1.55) |
Yes |
1.00 (reference) |
1.32 (1.00–1.75) |
1.00 (reference) |
1.33 (0.91–1.94) |
1.00 (reference) |
1.30 (0.86–1.95) |
Body mass index, kg/m2
|
|
|
|
|
|
|
<25.0 |
1.00 (reference) |
1.29 (1.09–1.53) |
1.00 (reference) |
1.10 (0.84–1.43) |
1.00 (reference) |
1.46 (1.16–1.83) |
≥25.0 |
1.00 (reference) |
1.18 (0.96–1.44) |
1.00 (reference) |
1.31 (1.01–1.69) |
1.00 (reference) |
1.02 (0.74–1.40) |