Effect of smoking and sedentary behavior on the association between depressive symptoms and mortality from coronary heart disease☆
Section snippets
Patient population
Patients admitted to Duke University Medical Center for diagnostic coronary angiography between October 1974 and February 1980 were asked to participate in a study of the associations between psychosocial constructs and CAD. The study was approved by the institutional review committee at Duke. Those who consented were enrolled if they were medically stable, admitted for their first cardiac catheterization, able to read at least at a sixth grade level, and found to have significant CAD (≥75%
Associations among depressive symptoms, smoking, exercise, and mortality
Survival among those who did and did not have depression data at baseline did not differ after control for illness severity and treatment status. The ordinal logit model showed that higher depressive symptom scores at baseline were associated with increased likelihood of a high-risk pattern of behavior for smoking, with a difference of 2 SDs associated with an odds ratio of 1.42 (p <0.01). Similarly, baseline depressive symptoms were positively associated with a pattern of sedentary behavior
Discussion
Although extensive research has documented the association between depression and mortality in patients with CAD, the mechanisms underlying this association are not well understood.
The present findings suggest that smoking and sedentary behavior may partially account for the relation between depressive symptoms and mortality; however, the extent of this mediation was modest. Moreover, the present findings are strengthened by the fact that they included follow-up assessments of smoking and
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This research was supported in part by Grants P01-HL36587, R01-HL55356, and R01-HL54780 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.