Depression Contributes to Heart Attack Risk in HIV-Positive People

People with the human immunodeficiency virus (HIV) who are depressed have a 30% increased risk for acute myocardial infraction (AMI) when compared to non-depressed people with HIV, according to a new study in the Journal of the American Medical Association (JAMA) Cardiology.

It’s been known that those with HIV have a higher risk of being depressed, but how that affects cardiovascular events hasn’t been fully explored. Matthew S. Freiberg, MD, MSc, from the Vanderbilt University School of Medicine, and colleagues examined a cohort from the US Department of Veterans Affairs Veterans Aging Cohort Study from April 2003 to December 2009.

“With the advent of highly effective antiretroviral therapy and improved survival, people with HIV-infection are living longer and are now at an increased risk for cardiovascular disease (CVD),” a JAMA statement said. “There is an urgent need to identify novel risk factors and primary prevention approached for CVD in HIV.”

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The cohort 26,144 HIV-infected veterans with an average of 48. None of the participants had CVD, but 4,853 of them (19%) had major depressive disorder (MDD) at baseline. A total of 490 AMI events (1.9%) out of all the participants during the six years of follow-up.

The people who had MDD at baseline had an increased risk of AMI when adjusted for demographics (hazard ratio (HR): 1.31), CVD risk factors (HR: 1.29), and HIV-specific factors (HR: 1.30). There was also an association with comorbidities: hepatitis C, renal disease, substance abuse, and hemoglobin level had an HR of 1.25. Antidepressant use had an HR of 1.12, but baseline dysthymic disorder did not appear to increase AMI risk.

“Our findings raise the possibility that, similar to the general population, MDD may be independently associated with incident atherosclerotic CVD in the HIV-infected population,” the authors concluded. Future research — which includes women – are needed to confirm these findings.

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