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Cardiovascular Psychiatry and Neurology
Volume 2013 (2013), Article ID 979185, 10 pages
Research Article

Sex Differences in Associations of Depressive Symptoms with Cardiovascular Risk Factors and Metabolic Syndrome among African Americans

1Northwest HSR&D Center of Excellence, VA Puget Sound Health Care System, 1100 Olive Way, Suite 1400, Seattle, WA 98101, USA
2Department of Health Services, University of Washington, Seattle, WA 98195, USA
3Department of Medicine, University of Washington, Seattle, WA 98195, USA
4Health Services and Epidemiology, University of Washington, Seattle, WA 98195, USA
5National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
6Department of Psychology, University of Maryland Baltimore County, Baltimore, MD 21250, USA
7Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD 21201, USA

Received 30 May 2013; Revised 7 August 2013; Accepted 8 August 2013

Academic Editor: Janusz K. Rybakowski

Copyright © 2013 Denise C. Cooper et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Young to middle-aged women usually have notably lower rates of cardiovascular disease (CVD) than their male counterparts, but African American women lack this advantage. Their elevated CVD may be influenced by sex differences in associations between depressed mood and CVD risk factors. This cross-sectional study examined whether relations between scores on the Center for Epidemiologic Studies-Depression (CES-D) scale and a spectrum of CVD risk factors varied by sex among African Americans ( ; ages 30–64) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Sex-stratified multiple regressions and logistic regressions were conducted. Among women, CES-D scores correlated positively with systolic blood pressure and waist-to-hip ratio ( ), but inversely with high-density lipoprotein cholesterol (HDL-C) ( ). Women had twice the odds for metabolic syndrome if CES-D scores ≥16 and had a ≥14% increase in odds of hypertension, abdominal obesity, and low HDL-C with each 5-unit increase in CES-D scores. Among men, CES-D scores correlated positively with high-sensitivity C-reactive protein ( ), and odds of hypertension increased by 21% with each 5-unit increase in CES-D scores. Depressive symptoms may promote premature CVD risk in African Americans, at least in part, via CVD risk factors and prevalent metabolic syndrome, particularly in African American women.