Association of Major Depression With Risk of Ischemic Heart Disease in a Mega‐Cohort of Chinese Adults: The China Kadoorie Biobank Study
Authors: Liu Na , Pan Xiong‐Fei , Yu Canqing , Lv Jun , Guo Yu , Bian Zheng , Yang Ling , Chen Yiping , Wu Tangchun , Chen Zhengming , Pan An , Li Liming , Chen Junshi , Collins Rory , Peto Richard , Lancaster Garry , Yang Xiaoming , Williams Alex , Smith Margaret , Chang Yumei , Zhao Guoqing , Wu Lixue , Hou Can , Pang Zengchang , Wang Shaojie , Zhang Yun , Zhang Kui , Liu Silu , Zhao Zhonghou , Liu Shumei , Pang Zhigang , Feng Weijia , Wu Shuling , Yang Liqiu , Han Huili , He Hui , Pan Xianhai , Wang Shanqing , Wang Hongmei , Hao Xinhua , Chen Chunxing , Lin Shuxiong , Hu Xiaoshu , Zhou Minghao , Wu Ming , Wang Yeyuan , Hu Yihe , Ma Liangcai , Zhou Renxian , Xu Guanqun , Dong Baiqing , Chen Naying , Huang Ying , Li Mingqiang , Meng Jinhuai , Gan Zhigao , Xu Jiujiu , Liu Yun , Wu Xianping , Gao Yali , Zhang Ningmei , Luo Guojin , Que Xiangsan , Chen Xiaofang , Ge Pengfei , He Jian , Ren Xiaolan , Zhang Hui , Mao Enke , Li Guanzhong , Li Zhongxiao , He Jun , Liu Guohua , Zhu Baoyu , Zhou Gang , Feng Shixian , Gao Yulian , He Tianyou , Jiang Li , Qin Jianhua , Sun Huarong , Liu Liqun , Yu Min , Chen Yaping , Hu Zhixiang , Hu Jianjin , Qian Yijian , Wu Zhiying , Chen Lingli , Liu Wen , Li Guangchun , Liu Huilin , Long Xiangquan , Xiong Youping , Tan Zhongwen , Xie Xuqiu , Peng Yunfang 
Published: December 2016

Background

Increasing evidence has suggested that major depression (
MD
) is associated with an increased risk of ischemic heart disease (
IHD
). We examined this association in Chinese adults using data from the China Kadoorie Biobank study.

Methods and Results

Over 0.5 million adults aged 30 to 79 years were followed from baseline interview (2004–2008) until December 31, 2013. Past year
MD
was measured with the modified Chinese version of Composite International Diagnostic Interview‐Short Form at baseline. Incident
IHD
cases were identified through linkage to related medical databases, and defined as having
International Statistical Classification of Diseases and Related Health Problems
10th Revision codes of I20 to I25. Cox proportional hazards regression models were used to estimate hazard ratios and 95%
CI
s for the
MD
‐
IHD
association with adjustment for sociodemographic variables and established cardiovascular risk factors. During 3 423 542 person‐years of follow‐up, 24 705 incident
IHD
cases were documented. Higher
IHD
incidence was observed in participants with
MD
compared with those without (8.76 versus 7.21 per 1000 person‐years), and the multivariable‐adjusted hazard ratio was 1.32 (95%
CI
1.15–1.53). Geographic location modified the association (
P
for interaction=0.005), and a positive association was observed in urban residents (hazard ratio 1.72; 95%
CI
1.39–2.14) but not rural residents (1.13; 0.93–1.37). Compared with participants without depressive symptoms, the hazard ratio (95%
CI
) of
IHD
was 1.13 (1.04–1.23) for those with depressive symptoms only and 1.33 (1.15–1.53) for those with
MD
.

Conclusions

Past year major depression was associated with an increased risk of
IHD
in Chinese adults, independent of other major cardiovascular risk factors.