{"id":"fafa07295772","type":"article","url":"https://hartvaat.nl/2026/03/02/is-depressie-een-onafhankelijke-risicofactor-voor-sterfte-bij-hart-en-vaatziekte/","title":"Is depressie een onafhankelijke risicofactor voor sterfte bij hart- en vaatziekten? Mogelijk niet (NHANES)","title_en":"Depression may not be an independent risk factor for mortality in patients with cardiovascular disease: data from NHANES 2011-2018","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":["vrouwen"],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003754?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003754?rss=1","authors":["Nguyen","B. T.","Li","Y.-C.","Dang","H. N.","Nguyen","H. T.","Thai","N. T. H.","Nguyen","D. T.","Nguyen","Q. T.","Nguyen","D. T. K.","Le","H. T. N.","Nguyen","V. N. B.","Tran","A. V."],"significance":5,"published":"2026-03-02","source_date":"2026-03-02","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"Depression is common in cardiovascular disease (CVD) and has long been regarded as an independent risk factor for higher mortality, although this association may be confounded by symptom overlap and residual confounding. In this secondary analysis of 2,064 adults with CVD (NHANES 2011-2018, linked to mortality data), depression was defined using the PHQ-9 (cut-off ≥10). Over a median 4.67-year follow-up, 403 deaths were recorded. In a basic adjusted Cox model, depression was associated with higher all-cause (HR 1.33) and non-cardiovascular mortality (HR 1.46). After rigorous adjustment with propensity score matching and inverse probability weighting, however, these associations were no longer significant. After thorough adjustment for confounders and comorbidity, depression may thus not be an independent risk factor for mortality in patients with cardiovascular disease.","created":"2026-07-03T10:32:24Z","updated":"2026-07-03T13:31:21Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Depressie komt veel voor bij hart- en vaatziekten (HVZ) en wordt al lang gezien als een onafhankelijke risicofactor voor hogere sterfte, al kan dit verband vertekend zijn door symptoomoverlap en restconfounding. In deze secundaire analyse van 2.064 volwassenen met HVZ (NHANES 2011-2018, gekoppeld aan sterftegegevens) werd depressie gedefinieerd met de PHQ-9 (afkapwaarde ≥10). Over een mediane follow-up van 4,67 jaar werden 403 sterfgevallen geregistreerd. In een basaal gecorrigeerd Cox-model was depressie geassocieerd met een hogere totale sterfte (HR 1,33) en niet-cardiovasculaire sterfte (HR 1,46). Na strenge correctie met propensity score-matching en inverse-probability-weging waren deze verbanden echter niet langer significant. Na grondige correctie voor confounders en comorbiditeit blijkt depressie dus mogelijk géén onafhankelijke risicofactor voor sterfte bij patiënten met hart- en vaatziekten.","abstract_original":"Background\n

Cardiovascular disease (CVD) is the leading cause of mortality worldwide, while depression is highly prevalent in this patient population and has long been regarded as an independent risk factor for increased mortality. However, recent evidence suggests that this association may be influenced by symptom overlap and residual confounding that has not been fully accounted for.

\n\nObjectives\n

This study aimed to evaluate the association between clinically significant depressive symptoms and the risk of all-cause, cardiovascular and non-cardiovascular mortality in adults with CVD.

\n\nMethods\n

We conducted a secondary analysis of 2064 adults with a history of CVD using data from the National Health and Nutrition Examination Survey 2011–2018 linked with the National Death Index. Depression was defined using the Patient Health Questionnaire-9 with a cut-off score of 10 or higher. Primary outcomes were all-cause, cardiovascular and non-cardiovascular mortality. Statistical analyses were performed using R software. We employed multivariable Cox regression models as well as propensity score matching and inverse probability weighting to control for potential confounders.

\n\nResults\n

Over a median follow-up of 4.67 years, 403 deaths were recorded. In an adjusted multivariable Cox model controlling for age, sex and race, depression was associated with an increased risk of all-cause mortality (HR 1.33; 95% CI 1.02 to 1.75) and non-cardiovascular mortality (HR 1.46; 95% CI 1.04 to 2.05). However, after applying propensity score matching and inverse probability weighting, these associations were no longer statistically significant for any mortality outcome.

\n\nConclusions\n

After rigorous adjustment for confounders and comorbidities, depression was no longer identified as an independent risk factor for mortality among patients with CVD.

\n"}