Association of Depression with Atherogenic Index among Patients Attending a Cardiology Clinic in Southern Nigeria

Introduction: Cardiovascular diseases (CVDs) are a leading cause of death worldwide. Atherogenic Index of Plasma (AIP) (log10 triglyceride TG/high density lipoprotein cholesterol HDL-C) predicts CVD risk. Depression is a common finding in patients with CVD and a contributory factor to cardiac related deaths and all-cause mortality. AIP has been found to be increased in patients with CVD who were also found to be depressed. We determined the prevalence of depression and its relationship with AIP in patients attending a cardiology clinic for various cardiac related ailments.

Study Design: Cross-sectional study.

Methods: Ninety four adult patients were recruited. None of the patients were receiving cholesterol lowering medications or antidepressants. Demographic, clinical data and anthropometric measurements were taken. Fasting lipid profiles inclusive of HDL‑C and TG were recorded. AIP of -0.3-0.11, 0.11-0.24 and >0.24 were classified as low, intermediate and high risk respectively. The Center for Epidemiologic Studies-Depression (CES-D) scale was used to assess depressive symptoms. A score ≥16 on the CESD was used as an indicator for elevated depressive symptoms (EDSs) associated with clinical depression based on the diagnostic and statistical manual (DSM IV).

Results: Majority of the patients were middle aged (52.1%), married (73.4%), female (59.6%), overweight (41.5%) with tertiary level of education (44.7%). Prevalence of depression was 28.7%. Persons with primary education had reduced odds of being depressed compared to those with no formal education, 92% O.R 0.08 (0.001 - 0.89), p=0.04. The most common diagnosis was hypertension (69.1%). Others were heart failure (20.2%), stroke (7.4%) and ischaemic heart disease (3.2%). There was a significantly positive but weak correlation between AIP with CESD scores (r= 0.28, p= 0.006).

Conclusion: Comorbid depression in patients with CVDs are often missed, undiagnosed and untreated. Routine screening for comorbid depression is recommended, and further studies are needed to understand the interaction between atherogenic index and depression to improve morbidity and ensure long-term survival of patients.