ArticleJAMA2008
Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease.
Article in JAMA, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 357 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Mental Health Through Integration With Primary Care in Rural Karnataka
Mindfulness-Based Cognitive Therapy Delivered Via Group Videoconferencing for Acute Coronary Syndrome Patients With Elevated Depression Symptoms
Who cites it
357 citing papers in PubMed, 9 syntheses or guidelines pooled it, 879 citations in OpenAlex.
- Impact of depression on medication non-adherence in coronary artery disease: a systematic review and meta-analysis.Open heart · 2025Pooled it
- Meta-analysis on inflammation and autonomic nervous system of coronary heart disease combined with depression.BMJ open · 2024Pooled it
- Association between depression and stroke risk in adults: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- Psychological and pharmacological interventions for depression in patients with coronary artery disease.The Cochrane database of systematic reviews · 2021Pooled it
- Associations of depression status with plasma levels of candidate lipid and amino acid metabolites: a meta-analysis of individual data from three independent samples of US postmenopausal women.Molecular psychiatry · 2021Pooled it
- Association of Efficacy of Resistance Exercise Training With Depressive Symptoms: Meta-analysis and Meta-regression Analysis of Randomized Clinical Trials.JAMA psychiatry · 2018Pooled it
- Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: A systematic review and meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2018Pooled it
- Anxiety disorders and all-cause mortality: systematic review and meta-analysis.Social psychiatry and psychiatric epidemiology · 2016Pooled it
- Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.PloS one · 2015Pooled it
- Long-term cardiac outcomes of depression screening, diagnosis and treatment in patients with acute coronary syndrome: the DEPACS study.Psychological medicine · 2021Trial
- No impact of an extensive social intervention program on return to work and quality of life after acute cardiac event: a cluster-randomized trial in patients with negative occupational prognosis.International archives of occupational and environmental health · 2019Trial
- Trial
- Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial.Journal of medical Internet research · 2018Trial
- Symptom Diary Use and Improved Survival for Patients With Heart Failure.Circulation. Heart failure · 2017Trial
- Association Between Cardiovascular Risk and Depressive Symptoms Among People With Serious Mental Illness.The Journal of nervous and mental disease · 2017Trial
- Effects of a nurse-coordinated prevention programme on health-related quality of life and depression in patients with an acute coronary syndrome: results from the RESPONSE randomised controlled trial.BMC cardiovascular disorders · 2016Trial
- Cardiac Risk Markers and Response to Depression Treatment in Patients With Coronary Heart Disease.Psychosomatic medicine · 2016Trial
- Depression, coronary artery disease, and physical activity: how much exercise is enough?Clinical therapeutics · 2014Trial
- Cardiovascular health and depression among postpartum women in the United States.American journal of preventive cardiology · 2026Article
- Social Determinants of Health, Depression, and Cardiovascular Health Among Veterans and Civilians: Insights From the 2013-2018 and 2021-2023 National Health and Nutrition Examination Survey.Preventing chronic disease · 2026Article
297 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
contextDepressive symptoms predict adverse cardiovascular outcomes in patients with coronary heart disease, but the mechanisms responsible for this association are unknown.
objectiveTo determine why depressive symptoms are associated with an increased risk of cardiovascular events. DESIGN AND
participantsThe Heart and Soul Study is a prospective cohort study of 1017 outpatients with stable coronary heart disease followed up for a mean (SD) of 4.8 (1.4) years.
settingParticipants were recruited between September 11, 2000, and December 20, 2002, from 12 outpatient clinics in the San Francisco Bay Area and were followed up to January 12, 2008.
main outcome measuresBaseline depressive symptoms were assessed using the Patient Health Questionnaire (PHQ). We used proportional hazards models to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events (heart failure, myocardial infarction, stroke, transient ischemic attack, or death) was explained by baseline disease severity and potential biological or behavioral mediators.
resultsA total of 341 cardiovascular events occurred during 4876 person-years of follow-up. The age-adjusted annual rate of cardiovascular events was 10.0% among the 199 participants with depressive symptoms (PHQ score > or = 10) and 6.7% among the 818 participants without depressive symptoms (hazard ratio [HR], 1.50; 95% confidence interval, [CI], 1.16-1.95; P = .002). After adjustment for comorbid conditions and disease severity, depressive symptoms were associated with a 31% higher rate of cardiovascular events (HR, 1.31; 95% CI, 1.00-1.71; P = .04). Additional adjustment for potential biological mediators attenuated this association (HR, 1.24; 95% CI, 0.94-1.63; P = .12). After further adjustment for potential behavioral mediators, including physical inactivity, there was no significant association (HR, 1.05; 95% CI, 0.79-1.40; P = .75).
conclusionIn this sample of outpatients with coronary heart disease, the association between depressive symptoms and adverse cardiovascular events was largely explained by behavioral factors, particularly physical inactivity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.