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Effect of depression treatment on health behaviors and cardiovascular risk factors in primary care patients with depression and elevated cardiovascular risk: data from the eIMPACT trial.
Schuiling, Matthew D; Shell, Aubrey L; Callahan, Christopher M; Nurnberger, John I; MacDonald, Krysha L; Considine, Robert V; Wu, Wei; Hirsh, Adam T; Crawford, Christopher A; Williams, Michelle K; Lipuma, Timothy C; Gupta, Samir K; Kovacs, Richard J; Rollman, Bruce L; Stewart, Jesse C.
Afiliación
  • Schuiling MD; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Shell AL; Ball Memorial Outpatient Behavioral Health, Indiana University Health, Muncie, IN, USA.
  • Callahan CM; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Nurnberger JI; Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Health, Indianapolis, IN, USA.
  • MacDonald KL; Department of Psychiatry and Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Considine RV; Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Health, Indianapolis, IN, USA.
  • Wu W; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Hirsh AT; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Crawford CA; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Williams MK; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Lipuma TC; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Gupta SK; Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA.
  • Kovacs RJ; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Rollman BL; Division of Cardiovascular Disease, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Stewart JC; Center for Behavioral Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Psychol Med ; : 1-14, 2024 Sep 10.
Article en En | MEDLINE | ID: mdl-39252547
ABSTRACT

BACKGROUND:

Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk.

METHODS:

Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange.

RESULTS:

The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on 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), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (p = 0.39).

CONCLUSIONS:

Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02458690.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychol Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychol Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido