DEPRESSION AND THE RISK OF CORONARY HEART-DISEASE IN THE NORMATIVE AGING STUDY

Increasing evidence supports an association between symptomatic depres sion and the risk of coronary heart disease (CHD), although no single study has compared multiple depression scales, We hypothesized that hi gher levels of symptomatic depression assessed from different depressi on scales were associated with the risk of CHD. We examined this relat ion in the Normative Aging Study, a prospective cohort of older men. A total of 1,305 men free of diagnosed CHD in 1986 completed the revise d Minnesota Multiphasic personality Inventory (MMPI-2), We categorized scores for the MMPI-2 D, MMPI-2 DEP, and Symptom Checklist-90 (SCL-90 ) depression scales, During an average 7.0 years of follow-up, 110 cas es of incident CHD occurred, including 30 cases of nonfatal myocardial infarction, 20 cases of fatal CHD, and 60 cases of angina pectoris, C ompared with men reporting the lowest level of depression, men in the highest level of depression had multivariate-adjusted relative risks o f incident CHD (total CHD and angina) of 1.46 (95% confidence interval 0.83 to 2.57), 2.07 (95% confidence interval 1.13 to 3.81), and 1.73 (95% confidence interval 0.97 to 3.10) for the MMPI-2 D, MMPI-2 DEP, a nd SCL-90 scales, respectively, Similar RRs were obtained for each CHD subtype according to each depression scale. We found strong dose-resp onse relations between level of depression measured by the MMPI-2 DEP scale and incidence of both angina pectoris (p value for trend, 0.039) and CHD (p value for trend, 0.016). Among older men, symptomatic depr ession measured by any of 3 depression scales may be positively associ ated with the risk of CHD. (C)1998 by Excerpta Medica, Inc.