Depressive symptoms and carotid artery intima-media thickness in police officers

Nov 28, 2012International archives of occupational and environmental health

Depressive symptoms linked to artery wall thickness in police officers

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Abstract

Among 412 police officers, depressive symptoms are associated with an increased carotid artery intima-media thickness (CIMT) in those without hypertension.

Depressive symptoms were assessed using the Center for Epidemiological Studies Depression (CES-D) scale.
A significant association was found between CES-D scores and common carotid artery intima-media thickness (CCA IMT) in officers without hypertension (adjusted P = 0.030).
No significant associations were observed between CES-D scores and maximum CIMT (MMXIMT) in either hypertensive or non-hypertensive officers.
Mean levels of CCA IMT and MMXIMT tended to increase with worsening depressive symptoms among officers reporting poor sleep quality.
Hypertension status significantly modified the relationship between depressive symptoms and CIMT.

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PURPOSE: Police work is a stressful occupation. Depressive symptoms, which may occur as a result of exposure to stressors in police work, have been known to be associated with an increased risk of cardiovascular disease. This cross-sectional study investigated the association between depressive symptoms and carotid artery intima-media thickness (CIMT) among police officers.

METHODS: CIMT was measured with B-mode carotid ultrasonography. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Analyses of variance and covariance were utilized to examine the mean values of common CIMT (CCA IMT) and maximum CIMT (MMXIMT) across quintiles of depressive symptoms.

RESULTS: Participants included 412 officers (mean age = 41 years). Hypertension status significantly modified the association between CES-D score and CIMT. The association between CES-D score and CCA IMT was statistically significant (adjusted P = 0.030) but only among officers without hypertension. The associations between CES-D score and MMXIMT were not significant among officers with or without hypertension. Our results also showed that among officers who reported poor sleep quality, mean levels of CCA IMT, and MMXIMT tended to increase as depressive symptoms increased.

CONCLUSIONS: Depressive symptoms may be therefore be independently associated with CIMT, yet masked by hypertension. Even though sleep quality did not significantly modify the main association, our results also suggest that poor sleep quality may act synergistically with depressive symptoms to increase CIMT. Future prospective work would help to clarify these associations.

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Depressive symptoms and carotid artery intima-media thickness in police officers

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