Sex-specific risks for cardiovascular disease across the specific depressive symptoms spectrum: A national prospective cohort study.

BACKGROUND

To examine sex-specific risks for cardiovascular disease across the specific depressive symptoms spectrum: a national prospective cohort in China.

METHODS

Using data from the China Health and Retirement Longitudinal Study (CHARLS), involving 11,735 individuals aged 45 and older in China. Ten specific depressive symptoms, assessed at baseline using the CES-D short form. Cox proportional hazard models estimated hazard ratios (HRs) for each symptom's association with CVD.

RESULTS

During the 7 years of follow-up, 1246 (20.8 %) incident CVD cases were identified among women, compared to 985 (17.1 %) among men. All ten specific depressive symptoms exhibited a higher incidence in women than in men. Nine of these symptoms were associated with an increased risk of CVD in both sexes. Restless sleep was more strongly associated with CVD in women (HR, 1.44; 95 % CI, 1.28-1.62) than in men (HR, 1.18; 95 % CI, 1.04-1.34) at baseline (P = 0.013 for interaction), whereas the HRs for other specific depressive symptoms were similar among women and men. Loneliness was the most important symptom for CVD risk in men, while restless sleep was the most significant for women.

CONCLUSIONS

Nine of 10 specific depressive symptoms may increase the risk of CVD in Chinese adults, regardless of gender. Notably, the association between restless sleep and CVD was strong in women, while loneliness showed a stronger association with CVD in men. These findings highlight the importance of considering specific depressive symptoms in assessing CVD risk among middle-aged and older adults, particularly across sexes.