Purpose Describe prevalence and relationships to cardiovascular morbidity of depression anxiety

Purpose Describe prevalence and relationships to cardiovascular morbidity of depression anxiety and medication use among Hispanic/Latinos of different ethnic backgrounds. and between insured (8.2%) and uninsured (1.8%). Conclusions Among US Hispanics/Latinos high depression and anxiety symptoms varied nearly twofold by Hispanic background and sex history of CVD and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population suggesting under treatment especially among those who had no health insurance. Keywords: depression anxiety Hispanics Latinos ethnic differences antidepressants antianxiety medications HCHS/SOL cardiovascular risk INTRODUCTION Depressive symptoms depressed mood or subclinical depression as well as anxiety assessed with screening instruments has been associated with higher risks of heart disease stroke and all-cause mortality 1-3 4 There is a bidirectional relationship between depression ARQ 197 and cardiovascular disease (CVD) with depression being common post myocardial infarction (MI)5 and post stroke6. While the study by Alegria and colleagues7 from the National Latino and Asian American Study (NLAAS) examined a probability sample of 2 554 persons from four background groups: Mexicans Puerto Ricans Cubans and “other” it did not distinguish those of Dominican South American or Central American backgrounds. Another important study from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (CPES) looked only at Mexican Puerto Rican and Cuban background groups. Little research exists on use of anti-depression and anti-anxiety medications in these diverse groups. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) the largest most comprehensive study of the health of Hispanics/Latinos from 6 different national backgrounds consists of a probability sample of 16 415 Hispanic/Latino persons ages 18-74 in four different communities across the Unites States. HCHS/SOL provides a unique opportunity to examine depressive and anxiety symptomatology and use of antidepressant and anti-anxiety medications in Hispanic/Latino groups ARQ 197 of different national backgrounds by age sex and in relation to CVD and risk factors for CVD. METHODS Design Overview Setting and Participants The HCHS/SOL enrolled 16 415 self-identified Hispanic/Latino participants ages 18-74 in four ARQ 197 defined communities in the US: Bronx New York; San Diego California; Miami Florida; and Chicago Illinois to describe and study prospectively health and disease in Hispanic/Latinos from diverse origins including Mexican Puerto Rican Dominican Cuban Central American KIAA1836 and South American. The cohort was selected and enrolled between 2008-2011 through stratified multi-stage area probability sample of the four diverse regions each with high concentrations of specific Hispanic/Latino backgrounds allowing estimation of prevalence rates of diseases and risk factors for each background. Written informed consent was obtained from all participants. Details of the design recruitment and implementation of HCHS/SOL have been published elsewhere8 9 During their baseline visit participants completed questionnaires according to their language preference in English or Spanish that ARQ 197 included information on demographic behavioral psychosocial and physiological factors co-morbidities dietary and medications information cognitive scales and assessment of depression anxiety and acculturation. A blood draw glucose tolerance test blood pressure and other physical measurements were completed. Measurements Depressive symptoms were assessed with the 10-item form of Center for Epidemiological Studies Depression Scale CES-D1010. This scale is a subset of the original 20-item CES-D scale11 asking how often the respondent has experienced a symptom in the past week. Response categories range from “none of the time” to “most of the time”; On the full 20-item scale a cut-point of ≥ 16 out of a possible high of 60 indicates presence of significant depressive symptoms validated using the DSM-III criteria for clinical depression. For the shortened CES-D10 scale used here the cut-point ≥10 (out of a possible high of 30) has generally been used for screening purposes12-14. When measured against the ≥16 cut-point for the CES-D20 among 88 older adults the CES-D10 cut point of ≥10 had sensitivity of 96% ARQ 197 and specificity of 100%10. In another study of adults 60 – 74 years The Systolic Hypertension in the Elderly Program (SHEP) among 4613 men and women the cut-point of ≥10 on the CES-D10 showed a.