The association of depression and anxiety with cardiac autonomic activity: The role of confounding effects of antidepressantsHu, M. X., Milaneschi, Y., Lamers, F., Nolte, I. M., Snieder, H., Dolan, C. V., Penninx, B. W. J. H. & de Geus, E. J. C., Dec-2019, In : Depression and Anxiety. 36, 12, p. 1163-1172 10 p.
Research output: Contribution to journal › Article › Academic › peer-review
BACKGROUND: Depression and anxiety may unfavorably impact on cardiac autonomic dysregulation. However, it is unclear whether this relationship results from a causal effect or may be attributable to confounding factors. We tested the relationship between depression and anxiety with heart rate (HR) and heart rate variability (HRV) across a 9-year follow-up (FU) period and investigated possible confounding by antidepressant use and genetic pleiotropy.
METHODS: Data (no. of observations = 6,994, 65% female) were obtained from the longitudinal Netherlands Study of Depression and Anxiety, with repeated waves of data collection of HR, HRV, depression, anxiety, and antidepressant use. Summary statistics from meta-analyses of genome-wide association studies were used to derive polygenic risk scores of depression, HR, and HRV.
RESULTS: Across the 9-year FU, generalized estimating equations analyses showed that the relationship between cardiac autonomic dysregulation and depression/anxiety rendered nonsignificant after adjusting for antidepressant use. A robust association was found between antidepressant use (especially tricyclic antidepressants, selective serotonin, and noradrenalin reuptake inhibitors) and unfavorable cardiac autonomic activity across all waves. However, no evidence was found for a genetic correlation of depression with HR and HRV, indicating that confounding by genetic pleiotropy is minimal.
CONCLUSIONS: Our results indicate that the association between depression/anxiety and cardiac autonomic dysregulation does not result from a causal pathway or genetic pleiotropy, and these traits might therefore not be inevitably linked. Previously reported associations were likely confounded by the use of certain classes of antidepressants.
|Number of pages||10|
|Journal||Depression and Anxiety|
|Early online date||2019|
|Publication status||Published - Dec-2019|