Abstract
Background There are limited studies on the associations of both depressive symptom scores and specific depressive symptoms with cardiovascular disease (CVD) risk. our purpose was to analyze association of both depressive symptom scores and specific depressive symptoms with CVD among Chinese population with chronic pain. Methods We collected data from the China Health and Retirement Longitudinal Study (CHARLS) during 2011–2015. The primary endpoint of this study was CVD events, which was defined as heart disease or stroke. COX proportional hazards regression was performed to analyze the association of both depressive symptom scores and specific depressive symptoms with CVD events. Results 3401 individuals were included when followed up to 2015, including 304 participants with CVD and 3097 participants without CVD, establishing a CVD incidence of 8.94% after an average follow-up of 46.58 months. The adjusted restricted cubic spline (RCS) curves showed a linear relationship between depression symptom scores and CVD events (P for non-linearity > 0.05). Each 1-point increase in the depression symptom score was associated with a 2% increase in the incidence of CVD events (adjusted HR 1.02, 95% CI: 1.01–1.04). Only 2 specific depressive symptoms were significantly associated with CVD events: feeling hopeless (adjusted HR, 1.11, 95% CI: 1.02–1.22) and feeling lonely (adjusted HR, 1.14, 95% CI: 1.03–1.26). Conclusions This study revealed a significant positive association between elevated depressive symptom scores and high CVD incidence in individual with chronic pain, only two specific depressive symptoms (feeling hopeless and feeling lonely) were independently associated with the development of CVD.