Depression and mortality: Artifact of measurement and analysis?

Background Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data. Methods Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models. Results Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost. Limitations Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied. Conclusions These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping. CrownCopyright © 2013PublishedbyElsevierB.V.Allrightsreserved

Relationship between endothelial nitric oxide synthase gene polymorphisms and the risk of myocardial infarction in the Algerian population

Introduction: Endothelial nitric oxide synthase (eNOS), the enzyme in charge of nitric oxide production, plays a crucial role in vascular biology. However, the impact of single nucleotide polymorphisms (SNPs) affecting the gene encoding for eNOS (eNOS) on coronary artery diseases remains under debate and no data were available at present in populations originating from Mahghreb.Aim of the Study: Our purpose was to evaluate the association between the eNOS -786T/C and +894G/T SNPs and (i) the risk of myocardial infarction (MI) and (ii) variations in systolic (SBP) and diastolic (DBP) blood pressure values.Patients and Methods: Concerning MI, the SNPs were characterised in a casecontrol study (70 cases vs 68 controls) based on the male population originating from Oran, Algeria.Results: The associations with blood pressure values were assessed in anenlarged control group including 115 male subjects. Since the -786T/CSNP could not be associated to MI, the genotype distribution of the+894G/T genotypes signifi cantly differed between MI cases and controls(p=0.025). The risk of MI (odds ratio) associated to the +894G/T SNP wasestimated to 1.2 (95%CI=[1.03;1.32]). The haplotype analysis confi rmedthis association and the absence of impact of the -786T/C SNP. On the other hand, no consistent association was shown between the two SNPs and SBP or DBP.Conclusion: As observed in other populations, the eNOS +894G/T SNPwas associated with MI in the Algerian population but the mechanismunderlying the effect could not be related to variations in blood pressure.Keywords: Endothelial nitric oxide synthase, myocardial infarction, blood pressure, genetic epidemiology