2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

330110
Drug use modifies the association between Depression and Cardiovascular Disease


Monday, November 2, 2015

Hannah Crooke, MPH, Department of Epidmeiology/ Colleges of Public Health and Health Professions and Medicine, University of Florida, Gainesville, FL
Linda Cottler, PhD, MPH, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Shivani Khan, Epidemiology, University of Florida, Gainesville, FL
Catherine Striley, PhD, MSW, MPE, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Depression is associated with Cardiovascular Diseases (CVDs). Both depression and CVDs are associated with drug use. We hypothesized that drug use would modify the relationship between depression and CVDs.

Using cross-sectional data from HealthStreet, a community-based effort in Florida to reduce disparities in healthcare and research, we looked at the association between self-reported lifetime history of depression and one or more CVDs (heart attack, angina, coronary artery disease). We then assessed the lifetime use of one or more drugs (club drugs, cocaine, heroin, amphetamines, hallucinogens) as an effect modifier on the relationship between depression and CVDs.

Out of 5506 participants, 1304 (23.6%) had lifetime history of depression, 650 (11.8%) had lifetime CVD history, 1230 (22.3%) reported lifetime drug use, and 274 (4.9%) had both lifetime depression history and lifetime CVD history. Bivariate analyses indicated significant associations between depression and CVDs, CVDs and drug use, and depression and drug use. Therefore, we examined drug use as an effect modifier on the relationship between depression and CVDs using logistic regression. The Breslow-Day test indicated that drug use significantly modified the effect of depression on CVDs (p=0.02). Contrary to our hypothesis, the relationship between depression and CVDs was attenuated among drug users (Adjusted OR 1.69, 95% CI 1.24, 2.32) compared to non-drug users (Adjusted OR 2.19, 95% CI 1.75, 2.73).

While initially unexpected, results of this analysis may indicate that drug users are self-medicating to lessen depression. When depression is reduced, through any means, it may attenuate the relationship between depression and CVDs.

Learning Areas:

Epidemiology

Learning Objectives:
Differentiate between the odds of CVDs due to depression among drug users and non-drug users Formulate hypotheses about the possible mechanisms by which drug use attenuates the relationship between depression and CVDs

Keyword(s): Drug Abuse, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral scholar who has worked closely with HealthStreet staff, and conducted previous research using data from HealthStreet. My research mentor, Dr. Catherine Striley, is co-director of HealthStreet. I've studied the continuum of care provided by community health workers across the globe and have also studied co-morbid conditions related to mental health care and drug use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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