Abstract # 1767 Combined influence of depression and systemic inflammation on cardiovascular disease and all-cause mortality: Evidence for differential effects by gender in the English Longitudinal Study of Ageing

The aim of this study was to examine the combined association of depression and inflammation with the risk of cardiovascular disease (CVD) and all-cause mortality. We measured C-reactive protein (CRP) and depressive symptoms in 5328 men and women aged 52–89 years in the English Longitudinal Study of Ageing. Depressive symptoms were measured using the eight-item Centre for Epidemiological Studies Depression Scale. CRP was analysed from peripheral blood. Mortality was ascertained from national registers and associations with depression and inflammation estimated using Cox proportional hazard models. We identified 112 cardiovascular related and 420 all-cause deaths in men and 109 cardiovascular related and 334 all-cause deaths in women over a mean follow-up of 7.7 years. Men with both depression and high CRP (3–20 mg/L) had an increased risk of CVD mortality (hazard ratio; 95% confidence interval: 3.89; 2.04–7.44) and all-cause mortality (2.40; 1.65–3.48) after adjusting for age, socioeconomic variables and health behaviours. This considerably exceeds the risks associated with high CRP alone (CVD 2.43; 1.59–3.71, all-cause 1.49; 1.20–1.84). There was no significant increase in mortality risk associated with depression alone in men. In women, neither depression or inflammation alone or the combination of both significantly predicted cardiovascular or all-cause mortality. The combination of depressive symptoms and increased inflammation confers a considerable increase in cardiovascular mortality risk for men.