Depressive Symptoms and Cardiovascular Health by the American Heart Association's Definition in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

PLoS One. 2012;7(12):e52771. doi: 10.1371/journal.pone.0052771. Epub 2012 Dec 26.


Background: Depressive symptoms are associated with increased incident and recurrent cardiovascular events. In 2010, the American Heart Association published the Life's Simple 7, a metric for assessing cardiovascular health as measured by 4 health behaviors (smoking, physical activity, body mass index, diet) and 3 biological measures (cholesterol, blood pressure, glucose). The association between depressive symptoms and the Life's Simple 7 has not yet been explored.

Methods: Data from 20,093 participants ≥45 years of age who enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007 and who had complete data available on Life's Simple 7 components were used for these analyses. The prevalence of ideal, intermediate, and poor health on each Life's Simple 7 component and total Life's Simple 7 scores were compared between participants with and without depressive symptoms. Depressive symptoms were measured using the 4-item Centers for Epidemiologic Studies of Depression scale.

Results: Participants with depressive symptoms were more likely to have poor levels on each of the Life's Simple 7 components other than cholesterol [adjusted prevalence ratios (95% CI): smoking 1.41 (1.29-1.55); physical activity 1.38 (1.31-1.46); body mass index 1.09 (1.04-1.15); diet 1.08 (1.06-1.10); blood pressure 1.11 (1.02-1.21); glucose 1.24 (1.09-1.41)]. There was a graded association between increasing depressive symptoms and lower total Life's Simple 7 score.

Conclusion: Depressive symptoms are associated with worse cardiovascular health on the overall Life's Simple 7 and on individual components representing both health behaviors and biological factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans
  • Aged
  • American Heart Association
  • Coronary Disease / epidemiology*
  • Depression / epidemiology*
  • Diet
  • European Continental Ancestry Group
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sensitivity and Specificity
  • Smoking / epidemiology
  • Stroke / epidemiology*
  • Stroke / ethnology
  • Surveys and Questionnaires
  • United States / epidemiology