TY - JOUR
T1 - Prospective increases in depression symptoms and markers of inflammation increase coronary heart disease risk - The Whitehall II cohort study
AU - Piantella, Stefan
AU - Dragano, Nico
AU - Marques, Matthew
AU - McDonald, Stuart
AU - Wright, Brad James
N1 - Funding Information:
The authors declare that they have no conflicts of interest. The Whitehall II study is supported by grants from the Medical Research Council ; British Heart Foundation ; Health and Safety Executive ; Department of Health ; National Heart Lung and Blood Institute ( HL36310 ), US, NIH: National Institute on Aging , US, NIH; Agency for Health Care Policy Research ( HS06516 ); and the JD and CT MacArthur Foundation Research 18 Networks on Successful Midlife Development and Socio-economic Status and Health .
Funding Information:
This work was supported by a La Trobe University Postgraduate Research Scholarship.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Objective: Stress, inflammation, and depression are associated to coronary heart disease (CHD). However, how these constructs collectively contribute to CHD incidence is not well understood. For the first time, this study explored the concurrent relationship between workplace stress, depression symptomology and levels of low-grade inflammation with future CHD incidence. Methods: Data from the 5-year intervals at phase 5, 7, and 9 of the Whitehall II study (N = 8348, Mage = 56) provided measures of workplace stress, depression symptomology, inflammation (interleukin-6, C-reactive protein, fibrinogen), and CHD incidence. The proposed stress-inflammation-depression-CHD pathway was assessed with a longitudinal design incorporating a structural equation model (SEM) that measured if changes in stress, depression, and inflammation between phase 5 to phase 7 predicted first-time CHD events between phases 7 and 9. Results: The SEM empirically supported this proposed pathway and demonstrated excellent model fit, χ (72) = 3582.959, p <.001, CFI = 0.896, RMSEA = 0.076 (CI90 = 0.074, 0.079), while depression symptoms mediated the association between workplace stress and CHD incidence, B = 0.003 (CI90 = 0.001, 0.004). Further, survival analysis indicated that individuals with higher mean scores (across phases) of depression symptoms or fibrinogen levels were more likely to experience a first time CHD event. Conclusions: Increases in depression symptoms and fibrinogen levels may be good indicators of future CHD morbidity among older employees. Future research is encouraged to monitor negative affective states and the potential use of biobehavioural options to reduce depression and inflammation that may mitigate CHD risk.
AB - Objective: Stress, inflammation, and depression are associated to coronary heart disease (CHD). However, how these constructs collectively contribute to CHD incidence is not well understood. For the first time, this study explored the concurrent relationship between workplace stress, depression symptomology and levels of low-grade inflammation with future CHD incidence. Methods: Data from the 5-year intervals at phase 5, 7, and 9 of the Whitehall II study (N = 8348, Mage = 56) provided measures of workplace stress, depression symptomology, inflammation (interleukin-6, C-reactive protein, fibrinogen), and CHD incidence. The proposed stress-inflammation-depression-CHD pathway was assessed with a longitudinal design incorporating a structural equation model (SEM) that measured if changes in stress, depression, and inflammation between phase 5 to phase 7 predicted first-time CHD events between phases 7 and 9. Results: The SEM empirically supported this proposed pathway and demonstrated excellent model fit, χ (72) = 3582.959, p <.001, CFI = 0.896, RMSEA = 0.076 (CI90 = 0.074, 0.079), while depression symptoms mediated the association between workplace stress and CHD incidence, B = 0.003 (CI90 = 0.001, 0.004). Further, survival analysis indicated that individuals with higher mean scores (across phases) of depression symptoms or fibrinogen levels were more likely to experience a first time CHD event. Conclusions: Increases in depression symptoms and fibrinogen levels may be good indicators of future CHD morbidity among older employees. Future research is encouraged to monitor negative affective states and the potential use of biobehavioural options to reduce depression and inflammation that may mitigate CHD risk.
KW - Cardiovascular disease
KW - Fibrinogen
KW - Interleukin 6
KW - Job strain
KW - Negative affect
KW - Workplace stress
UR - http://www.scopus.com/inward/record.url?scp=85118324789&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychores.2021.110657
DO - 10.1016/j.jpsychores.2021.110657
M3 - Article
AN - SCOPUS:85118324789
SN - 0022-3999
VL - 151
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
M1 - 110657
ER -