Introduction:
Cardiovascular health (CVH) declines substantially in young adulthood, and mood disorders commonly emerge during this life stage. This study aimed to examine the association between CVH metrics and 1) depression and 2) anxiety among young adults ages 18-34 years.
Hypothesis:
We hypothesized that young adults with depression or anxiety will have less optimal CVH.
Methods:
We used data from the Emory Healthy Aging Study (EHAS), a prospective cohort study of US adults that aims to understand factors associated with aging. We conducted a cross-sectional analysis among participants ages 18-34 years who completed the EHAS Health History Questionnaire (n=882). We classified participants as having poor, intermediate, or ideal levels of the seven CVH metrics using definitions set forth by the AHA, with slight modifications as needed based on questionnaire items, and calculated total CVH scores (range 0-14). We defined depression and anxiety as absent, mild, or moderate-to-severe using standard cutoffs for Patient Health Questionnaire (PHQ-8) and General Anxiety Disorder (GAD) scales. We used multivariable regression to examine the association between CVH, depression, and anxiety, controlling for gender, race, age group, income, and education.
Results:
A total of 134 (15.2%) participants had moderate-to-severe anxiety, and 132 (15.0%) participants had moderate-to-severe depression. The mean total CVH score among participants was 10.4. Compared to those without anxiety, participants with moderate-to-severe anxiety were less likely to meet ideal levels of physical activity (PR: 0.63, 95% CI: 0.44-0.90), smoking (PR: 0.89, 95% CI: 0.81-0.98), and body mass index (PR: 0.78, 95% CI: 0.65-0.94). Participants with moderate-to-severe depression were less likely to meet ideal levels of cholesterol (PR: 0.93, 95% CI: 0.86-1.00), physical activity (PR: 0.45, 95% CI: 0.30-0.69), smoking (PR: 0.89, 95% CI: 0.79-0.99), blood pressure (PR: 0.91, 95% CI: 0.84-0.98), and body mass index (PR: 0.81, 95% CI: 0.71-0.93). Stratified analysis showed that these associations appeared stronger in older young adults (26-34 years). Relative to those without anxiety, participants with moderate-to-severe anxiety had a CVH score that was 0.91 points lower (standard error: 0.18, p-value<0.01). Relative to those without depression, participants with moderate-to-severe depression had a CVH score that was 1.19 points lower (standard error: 0.18, p-value<0.01).
Conclusion:
Anxiety and depression are associated with CVH in young adults. Interventions to address mood disorders in this age group should consider targeting CVH behaviors such as physical activity and weight management to improve both mood and CVH.