Abstract: FR-PO748
Depression and CKD as Risk Factors of Heart Failure: Post Hoc Analysis of SPRINT
Session Information
- Hypertension and CVD: Clinical, Outcomes, Trials
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials
Authors
- Abraham, Nikita, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Hartsell, Sydney Elizabeth, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Singh, Ravinder, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Wei, Guo, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Cheung, Alfred K., The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Greene, Tom, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Boucher, Robert E., The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Beddhu, Srinivasan, The University of Utah School of Medicine, Salt Lake City, Utah, United States
Background
Depression and HF are common in CKD. We examined whether the presence of depression augments the risk of HF in CKD.
Methods
We used data from SPRINT, a RCT that tested the effects of SBP goal <120 vs. <140 mmHg on CV outcomes. CKD was defined as eGFR <60. Based on the Patient Health Questionnaire (PHQ)-9, we defined 3 groups: no (score 0), minimal/mild (scores 1-9) and moderate/severe (scores 10-27) depressive symptoms. We related baseline PHQ9 groups and CKD status with adjudicated HF events during follow-up in Cox regression models.
Results
In 9,111 included participants, the mean age was 68±9 yrs., 36% were female, 31% were Black and 28% had CKD at baseline. Baseline characteristics by depression groups defined by PHQ9 scores are summarized(Table). There were 211 HF events over 34,340 years of follow-up. In a multivariable Cox regression model, higher PHQ9 scores (minimal/mild HR 1.43 (1.05, 1.96), moderate/severe HR 1.84 (1.09, 3.10)) and CKD (HR 3.33 (2.53, 4.37)) were each associated with HF. Highest HF risk was noted when both were present (Fig).
Conclusion
Both depression and CKD are risk factors for HF with the highest risk of HF seen when both are present. Interventions targeting depression might reduce the risk of HF in CKD.
Baseline characteristics by PHQ9 score (N = 9111)
| None (0) 34% | Minimal/Mild (1-9) 69% | Moderate (10-27) 7% | |
| PHQ-9 | 0 ± 0 | 3 ± 2 | 14 ± 4 |
| Age (y) | 69 ± 9 | 68 ± 10 | 63 ± 9 |
| Female (%) | 28 | 40 | 42 |
| Black (%) | 31 | 30 | 47 |
| Intensive SBP arm (%) | 50 | 50 | 51 |
| CVD History (%) | 18 | 21 | 23 |
| SBP (mmHg) | 140 ± 15 | 140 ± 16 | 139 ± 16 |
| DBP (mmHg) | 77 ± 12 | 78 ± 12 | 81 ± 12 |
| BMI, kg/m2 | 29 ± 5 | 30 ± 6 | 31 ± 7 |
| UACR (mg/g Cr) | 9 (5, 20) | 10 (6, 23) | 8 (5, 18) |
| eGFR (ml.min/1.73m2) | 72 ± 20 | 71 ± 21 | 75 ± 23 |
HF Incidence
Funding
- NIDDK Support