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- Title
Cardiac risk factors in patients with diabetes mellitus and major depression.
- Authors
Katon, Wayne J.; Lin, Elizabeth H. B.; Russo, Joan; Von Korff, Michael; Ciechanowski, Paul; Simon, Greg; Ludman, Evette; Bush, Terry; Young, Bessie
- Abstract
<bold>Objective: </bold>The prevalence of major depression is approximately 2-fold higher in patients with diabetes mellitus compared to medical controls. We explored the association of major depression with 8 cardiac risk factors in diabetic patients with and without evidence of cardiovascular disease (CVD).<bold>Design: </bold>A mail survey questionnaire was administered to a population-based sample of 4,225 patients with diabetes to obtain data on depression status, diabetes self-care (diet, exercise, and smoking), diabetes history, and demographics. On the basis of automated data we measured diabetes complications, glycosylated hemoglobin, medical comorbidity, low-density lipid levels, triglyceride levels, diagnosis of hypertension, and evidence of microalbuminuria. Separate analyses were conducted for subgroups according to the presence or absence of CVD.<bold>Setting: </bold>Nine primary care clinics of a nonprofit health maintenance organization.<bold>Main Results: </bold>Patients with major depression and diabetes were 1.5- to 2-fold more likely to have 3 or more cardiovascular risk factors as patients with diabetes without depression (62.5% vs 38.4% in those without CVD, and 61.3% vs 45% in those with CVD). Patients with diabetes without CVD who met criteria for major depression were significantly more likely to be smokers, to have a body mass index (BMI) > or = 30 kg/m2, to lead a more sedentary lifestyle, and to have HbA1c levels of >8.0% compared to nondepressed patients with diabetes without heart disease. Patients with major depression, diabetes, and evidence of heart disease were significantly more likely to have a BMI > or = 30 kg/m2, a more sedentary lifestyle, and triglyceride levels > 400 mg/dl than nondepressed diabetic patients with evidence of heart disease.<bold>Conclusions: </bold>Patients with major depression and diabetes with or without evidence of heart disease have a higher number of CVD risk factors. Interventions aimed at decreasing these risk factors may need to address treatment for major depression in order to be effective.
- Subjects
CARDIOVASCULAR diseases; DIABETES; DISEASE risk factors; MENTAL depression; PEOPLE with diabetes; MENTAL health; EPIDEMIOLOGY; INTERNAL medicine; DIABETES complications; TYPE 2 diabetes treatment; ALBUMINURIA; COMPARATIVE studies; GLYCOSYLATED hemoglobin; HYPERTENSION; LOW density lipoproteins; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; HEALTH self-care; SMOKING; TRIGLYCERIDES; EVALUATION research; BODY mass index; LIFESTYLES; DISEASE complications
- Publication
JGIM: Journal of General Internal Medicine, 2004, Vol 19, Issue 12, p1192
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1111/j.1525-1497.2004.30405.x