Symptoms of depression and active smoking among survivors of stroke and myocardial infarction: An NHANES analysis

PREVENTIVE MEDICINE

卷:137

Article

Parikh, Neal S.^1,2  Omran, Setareh Salehi³  Kamel, Hooman^1,2  Elkind, Mitchell S., V^4,5  Willey, Joshua⁴ 

[1] Weill Cornell Med, Clin & Translat Neurosci Unit, Feil Family Brain & Mind Res Inst, 420 E 70th St,4th Floor, New York, NY 10021 USA

[2] Weill Cornell Med, Dept Neurol, 420 E 70th St,4th Floor, New York, NY 10021 USA

[3] Univ Colorado, Dept Neurol, 12401 E 17th Ave,Leprino Bldg,4th Floor, Aurora, CO 80045 USA

[4] Columbia Univ, Vagelos Coll Phys & Surg, Dept Neurol, 710 W 168th 5t 6th Floor, New York, NY 10032 USA

[5] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, 710 W 168th St,6th Floor, New York, NY 10032 USA

关键词: Epidemiology;    Risk factors;    Secondary prevention;    Myocardial infarction;    Cerebrovascular disease/stroke;    Smoking;    Depression;   

DOI  :  10.1016/j.ypmed.2020.106131

来源: Elsevier

【 摘 要 】

Historic concerns about the cardiovascular and neuropsychiatric side effects of smoking-cessation pharmacotherapy have in part limited their use. We sought to evaluate whether depressive symptoms are associated with active smoking among survivors of stroke and myocardial infarction (MI). To do this, we performed a crosssectional analysis using data from the National Health and Nutrition Examination Survey (2005-2016). We included participants >= 20 years old with prior stroke or MI and any history of smoking. Symptoms of depression, at survey participation, were ascertained using the Patient Health Questionnaire-9. Active smoking was defined using self-report and, secondarily, with cotinine measures. We used logistic regression to evaluate the association between depression and active smoking after adjusting for demographics, smoking-related medical conditions, and health-related behaviors. We found that, among stroke and MI survivors with any history of smoking, 37.9% (95% CI, 34.5-41.3%) reported active smoking and 43.8% (95% CI, 40.3-47.3%) had biochemical evidence of smoking. Rates of active smoking were similar for stroke and MI survivors. Twenty-one percent screened positive for depression. In adjusted models, depression was associated with active smoking in the combined group of stroke and MI survivors (odds ratio, 2.28; 95% CI, 1.24-4.20) and in stroke survivors (odds ratio, 2.97; 95% CI, 1.20-7.38). Tests of heterogeneity by event type did not reveal an interaction. Findings were similar when using cotinine measures. We conclude that symptoms of depression were associated with active smoking among stroke and MI survivors. Stroke and MI survivors with symptoms of depression may require targeted smoking-cessation interventions.

【 授权许可】

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