This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lewis, T. T. Articles by Sutton-Tyrrell, K. Search for Related Content PubMed PubMed Citation Articles by Lewis, T. T. Articles by Sutton-Tyrrell, K. Related Collections Depression Coronary Artery Disease

Interactive Effects of Race and Depressive Symptoms on Calcification in African American and White Women

From the Department of Epidemiology and Public Health, Yale University School of Medicine (T.T.L.), New Haven, Connecticut; Department of Medicine and Program in Health Disparities Research, University of Minnesota (S.A.E.R.), Minneapolis, Minnesota; Department of Psychiatry, University of Pittsburgh School of Medicine (K.A.M., J.B.), Pittsburgh, Pennsylvania; and Graduate School of Public Health, University of Pittsburgh (K.A.M., J.B., K.S.T.), Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Tené T. Lewis, Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, 4^th floor. New Haven, CT 06510. E-mail: tene.lewis{at}yale.edu

Objective: To examine the cross-sectional associations among race, depressive symptoms, and aortic and coronary calcification in a sample of middle-aged women. Depressive symptoms have been associated with atherosclerotic indicators of coronary heart disease (CHD) in white women. Few studies have examined these associations in samples including African American women, or explored whether any observed associations differ by race.

Methods: Participants were 508 (38% African American, 62% white) women. Aortic and coronary calcification were measured by electron beam tomography and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariable linear and logistic regression models were conducted to test associations.

Results: In linear regression models adjusted for race, depressive symptoms were associated with a greater amount of aortic calcification (β = 0.03, p = .01), and there was a significant race x depressive symptoms interaction (β = 0.07, p = .006). Findings for depressive symptoms (odds ratio (OR) = 1.03, 95% Confidence Interval (CI) = 1.0–1.06, p = .07), and the race x depressive symptoms interaction (OR = 1.1, 95% CI = 1.01–1.18, p = .01) were similar in race-adjusted multinomial logistic regression models predicting high levels of aortic calcification. Race-specific models revealed a significant association between depressive symptoms and aortic calcification in African American, but not white women. Additional adjustments for education, study site, and CHD risk factors did not alter these results. Depressive symptoms were not associated with coronary calcification for women of either racial group.

Conclusions: African American women may be particularly vulnerable to the effects of depressive symptoms on early atherosclerotic disease.

Key Words: depressive symptoms • calcification • atherosclerosis • race • women • coronary heart disease

Abbreviations: CHD = coronary heart disease; SWAN = Study of Women's Health Across the Nation; EBT = electron beam tomography; CES-D = Center for Epidemiological Studies Depression; SES = socioeconomic status; FRS = Framingham Risk Score; HDL-c = high-density lipoprotein cholesterol; BMI = body mass index; OR = odds ratio; CI = Confidence Interval.

This article has been cited by other articles:

				M. O. Whipple, T. T. Lewis, K. Sutton-Tyrrell, K. A. Matthews, E. Barinas-Mitchell, L. H. Powell, and S. A. Everson-Rose Hopelessness, Depressive Symptoms, and Carotid Atherosclerosis in Women: The Study of Women's Health Across the Nation (SWAN) Heart Study Stroke, October 1, 2009; 40(10): 3166 - 3172. [Abstract] [Full Text] [PDF]