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School of Public Health (J.F.S., W.R.T.), St. Louis University Health Sciences Center; Research Service (J.F.S., H.X., S.A.E., W.R.T.), St. Louis Veterans Affairs Medical Center (VAMC); Medical Service (S.A.E.), St. Louis VAMC; Department of Internal Medicine, Division of General Medical Sciences (H.X., S.A.E.), and Department of Psychiatry (K.K.B.), Washington University School of Medicine, St. Louis, Missouri; Harvard Medical School, Harvard Institute of Psychiatric Epidemiology and Genetics (M.T.), and Department of Psychiatry, Massachusetts Mental Health Center, Boston (M.J.L., M.T.); Department of Psychology (M.J.L.), Boston University, Boston, Massachusetts; and Department of Veterans Affairs, Vietnam Era Twin Registry/Seattle Epidemiologic Research and Information Center and Department of Epidemiology (J.G.), University of Washington School of Public Health, Seattle, Washington
Address reprint requests to: J. F. Scherrer, MA, VAMC-St. Louis, Research Service 151-JC, 915 N. Grand Blvd., St. Louis, MO 63106. Email: scherrjf{at}SLU.EDU
Received for publication August 29, 2002; revision received October 15, 2002.
OBJECTIVE: Epidemiological and clinical studies have established an association between major depression and cardiovascular disease. We utilized a twin design to test whether there are common genetic and environmental risk factors underlying depression symptoms, hypertension and heart disease.
METHODS: Association studies were conducted with 6,903 male-male twins from the Vietnam Era Twin Registry who responded to both a 1990 health questionnaire and a 1992 telephone administration of a structured psychiatric interview. Data from 2,731 complete twin pairs were used to fit genetic models which determined the extent to which lifetime depression symptoms, heart disease and hypertension shared genetic and/or environmental factors.
RESULTS: Heart disease was significantly associated with 1–4 symptoms and 5 or more symptoms of depression (odds ratio [OR] = 2.62; 95% confidence interval [CI]: 1.54–4.46 and OR = 4.02; 95% CI: 2.16–7.46). Hypertension was significantly associated with 1 to 4 symptoms and 5 or more symptoms of depression (OR = 1.29; 95% CI: 1.11–1.50 and OR = 1.49; 95% CI: 1.21–1.83). The genetic correlations were significant between depression symptoms and hypertension (r = .19), and between depression symptoms and heart disease (r = .42). Of the total variance in depression, 8% was common to hypertension and heart disease, 7% of the variance in hypertension was common with depression symptoms and heart disease, and 64% of the variance in heart disease was common with depression symptoms and hypertension.
CONCLUSIONS: Men who reported cardiovascular disease were significantly more likely to have depression symptoms. The lifetime co-occurrence of these phenotypes is partly explained by common genetic risk factors.
Key Words: twins, • men, • depression, • hypertension, • heart disease.
Abbreviations: MZ = monozygotic;; DZ = dizygotic;; DIS = Diagnostic Interview Schedule.
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