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Greater mortality risk with comorbid coronary heart disease and depressive symptoms either condition alone

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Do depressive symptoms and coronary heart disease (CHD) interact to elevate the risk of death compared with each of these conditions alone?


5936 people with a median age of 61 years at baseline. Initial data were taken from phase 7 (2002–2004) of the British Whitehall II longitudinal study of civil servants. Participants aged 35–55 were originally recruited to the study in 1985. All participants with complete data at phase 7 were included in the analysis.


UK; 2002–2009.

Risk factors

Depressive symptoms and CHD, separately and as comorbidities. CHD was defined as non-fatal myocardial infarction or clinically confirmed angina based on examinations at phases 1, 3, 5 and 7 of the Whitehall study and review hospital and general practitioner records. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale at phase 7 through interview. Data were also collected on the following covariates: sociodemographics, behavioural risk factors including smoking status, exercise, alcohol consumption, biological factors including blood pressure, body mass index (BMI), heart rate and diabetes and medication use including cardiovascular disease (CVD) treatments.


Primary outcome: …

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  • Sources of funding Medical Research Council, British Heart Foundation, Health and Safety Executive, Department of Health, National Heart Lung and Blood Institute, National Institute on Ageing, Agency for Health Care Policy Research, John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic status and health.


  • Competing interests None.