For patients with type 2 diabetes, higher self-reported depression symptoms and antidepressant medicine (ADM) use in the previous year are independently associated with developing certain cardiovascular disease (CVD) risk factor-positive status over the next four years, according to a study published in Diabetes Care.

Richard R. Rubin, Ph.D., from Johns Hopkins University in Baltimore, and colleagues examined the correlation between depressive symptoms and ADM with subsequent CVD risk factors in the Look Action for Health in Diabetes (Look AHEAD) trial.

Depressive symptoms, assessed using the Beck Depression Inventory (BDI), were self-reported by 5,145 participants (mean age, 58.7 years) in two study arms (intensive lifestyle [ILI] and diabetes support and education [DSE]). Risk factors were assessed at baseline and annually for four years, and positive factors included current smoking, obesity, hemoglobin A1c (A1C) >7.0 percent or insulin use, and blood pressure or cholesterol above recommended levels.

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The researchers found that, for the DSE arm, prior-year elevated BDI was associated with subsequent CVD risk factor-positive status (A1C: odds ratio [OR], 1.30; total cholesterol: OR, 0.80) and with increased odds of high-density lipoprotein (HDL) and triglycerides for the ILI arm (ORs, 1.40 and 1.28). Previous-year ADM predicted future increased CVD risk status for HDL, total cholesterol, and current smoking in the DSE arm, and for A1C, HDL, triglycerides, systolic blood pressure, and obesity in the ILI arm.

“Aggressive monitoring of CVD risk in diabetic patients with depressive symptoms or who are treated with ADM may be warranted,” the authors write.

The Look AHEAD study was partially funded by contributions from the pharmaceutical and nutrition industries.