CVD risk remain high despite successful treatment for depression

A recent study suggests that successful treatment of depression alone is not enough to protect patients against the associated risk of cardiovascular disease (CVD).

Researchers conducted a secondary analysis of the eIMPACT trial data to assess the effect of modernized collaborative care for depression on CVD risk indicators. Over 12 months, CVD-relevant health behaviours (self-reported CVD prevention medication adherence, sedentary behaviour, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were evaluated. A statewide health information exchange facilitated recording of incident CVD events.

The analysis included 216 primary care patients (mean age 58.7 years, 78.2 percent female, 49.5 percent Black/African American) with depression and elevated CVD risk from the eIMPACT trial. Of these, 107 patients had been randomly allocated to the intervention group (internet cognitive-behavioural therapy [CBT], telephonic CBT, and select antidepressant medications) and 109 to the usual care group.

Compared with the usual care group, the intervention group had significantly greater improvements in depressive symptoms (p<0.01) and sleep quality (p<0.01) at 12 months. However, no between-group differences were seen in other outcomes such as systolic blood pressure (p=0.36), low-density lipoprotein cholesterol (p=0.38), high-density lipoprotein cholesterol (p=0.79), triglycerides (p=0.76), CVD prevention medication adherence (p=0.64), and sedentary behaviour (p=0.57). Diastolic blood pressure was notably better in the usual care group (p=0.02).

Finally, the likelihood of an incident CVD event was similar between the intervention and the usual care groups (12.1 percent vs 8.3 percent; p=0.39).