C-reactive protein in midlife is associated with depressive symptoms two decades later among men with coronary heart disease

Nord J Psychiatry. 2020 Apr;74(3):226-233. doi: 10.1080/08039488.2019.1695284. Epub 2019 Nov 26.


Aim: We investigated the relationship between midlife C-reactive protein (CRP) levels in men with coronary heart disease (CHD) and depressive symptoms at old age. CRP levels were measured in a subset of patients with CHD, who previously participated in a secondary prevention trial.Methods: Depressive symptoms were evaluated in survivors of the original cohort 15.0 ± 3 and 19.9 ± 1 years later (T1, n = 463 and T2, n = 314 respectively) using the Geriatric Depression Scale (GDS), 15-item version. Logistic regression was used to estimate ORs and 95%CIs for presence of potentially clinically significant depressive symptoms (GDS ≥5) at T1 and T2.Results: Adjusting for demographic and health-related variables, the OR (95%CI) for GDS ≥5 was 1.23 (0.65-2.33); p = .53 at T1 and 2.36 (1.16-4.83); p = .018 at T2 in the top CRP tertile compared to the others. Similarly, consistently high CRP levels in the top tertile at baseline and 2 years later, were associated with OR of 2.85 (95%CI 1.29-6.30); p = .01 for GDS ≥5 at T2.Conclusions: Presence and persistence of low-grade inflammation in men with CHD during midlife are associated with increased risk of depressive symptoms twenty years later. Among middle aged men with CHD, low-grade inflammation may provide an important added value for prediction of depression in old age.

Keywords: Coronary heart disease; depression; elderly; inflammation.

Publication types

  • Multicenter Study

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Cohort Studies
  • Coronary Disease / blood*
  • Coronary Disease / epidemiology
  • Coronary Disease / psychology*
  • Depression / blood*
  • Depression / epidemiology
  • Depression / psychology*
  • Humans
  • Israel / epidemiology
  • Male
  • Middle Aged


  • Biomarkers
  • C-Reactive Protein