Association between chest pain and risk of depression in patients with or without coronary heart disease

Hongwei Yuan; Ting Pan; Tiantian He; Junjie Liang; Yuqi Zhou; Chongyang Zhang; Yu Xing; Yuying Hong; Zhiguo Zhang; Peng Bai

doi:10.1016/j.jad.2025.01.013

Association between chest pain and risk of depression in patients with or without coronary heart disease

J Affect Disord. 2025 Jan 20:S0165-0327(25)00019-9. doi: 10.1016/j.jad.2025.01.013. Online ahead of print.

Authors

Hongwei Yuan¹, Ting Pan², Tiantian He², Junjie Liang³, Yuqi Zhou², Chongyang Zhang², Yu Xing², Yuying Hong⁴, Zhiguo Zhang⁵, Peng Bai⁶

Affiliations

¹ Department of Acupuncture and Moxibustion, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China.
² Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China.
³ Capital Medical University Beijing Hospital of Traditional Chinese Medicine, Beijing 100010, China.
⁴ Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing 100700, China.
⁵ China Academy of Chinese Medical Sciences Institute of Basic Theory in Chinese Medicine, Beijing 100700, China.
⁶ Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China. Electronic address: baipeng202305@163.com.

PMID: 39842676
DOI: 10.1016/j.jad.2025.01.013

Abstract

Background: Research on the relationship between chest pain and depression risk in patients with or without coronary heart disease (CHD) is limited.

Methods: This cross-sectional study includes adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. The diagnoses of chest pain and CHD were based on self-reports from participants, while depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). The study employs logistic regression, subgroup analysis, and sensitivity analysis to explore the association between chest pain and depressive symptoms, taking into account the influence of CHD.

Results: The study included 15,048 adults aged 20 years or older, with an average age of 59.6 ± 12.1 years, and 51.6 % were male. After adjusting for covariates, a significant difference in the association between chest pain and the risk of depression was observed between the non-CHD group and CHD group (non-CHD group: OR = 2.43, 95 % CI: 2.13-2.78; CHD group: OR = 1.2, 95 % CI: 0.72-1.98). Furthermore, subgroup analysis revealed an interaction between CHD status and chest pain that may reduce the prevalence of depression (P-value for interaction = 0.004). Sensitivity analysis confirmed the stability of the results.

Conclusion: Our findings suggest that the presence of CHD may influence the relationship between chest pain and depression risk among American adults. His conclusion requires further validation through randomized controlled trials.

Keywords: Chest pain; Coronary heart disease (CHD); Depression; NHANES.