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Background <p>Depression and diabetes mellitus (DM) are common comorbid conditions that could increase the risk of cardiovascular disease (CVD). This study investigated the independent and joint effects of DM and depression on the risk of CVD, coronary artery disease (CAD), and stroke.</p> Methods <p>This retrospective cohort study evaluated 7063 individuals for CVD, CAD, and stroke events in a 10-year follow-up. The participants were divided into four groups depending on whether they had DM or depression. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for demographic, lifestyle, and clinical covariates. Additive interaction was evaluated using the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).</p> Results <p>Total cardiovascular events were 830. Participants with both DM and depression had the highest risk of all cardiovascular outcomes. Compared with participants with neither condition, adjusted HRs were 2.93 for CVD, 2.85 for CAD, and 4.85 for stroke. While depression alone was not significantly associated with stroke, the coexistence of DM and depression was associated with more than a twofold higher risk of stroke compared with DM alone. Additive interaction analysis demonstrated a significant positive interaction for stroke (RERI = 2.084, AP = 0.430, S = 2.183), whereas no significant interaction was observed for CVD or CAD.</p> Conclusion <p>The coexistence of DM and depression was associated with significantly increased risks of CVD, CAD, and stroke. A significant synergistic effect was observed specifically for stroke, suggesting that depression may amplify the cerebrovascular consequences of DM.</p> Graphical abstract <p></p>

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Co-occurring diabetes and depression and their impact on CVD, CAD, and stroke risk over a 10-year follow-up: A cohort study

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Hossein Ghazaee,
  • Vahid Mahdavizadeh,
  • Ali Rezaee,
  • Susan Darroudi,
  • Mohsen Rezaee,
  • Habibollah Esmaily,
  • Mohsen Mehrabzadeh,
  • Hediye Erfaniyan Shahabi,
  • Hoda Sabbagh Sajadiyeh,
  • Reihaneh Alizadeh,
  • Majid Ghayour-Mobarhan,
  • Zahra Mazloum Khorasani

摘要

Background

Depression and diabetes mellitus (DM) are common comorbid conditions that could increase the risk of cardiovascular disease (CVD). This study investigated the independent and joint effects of DM and depression on the risk of CVD, coronary artery disease (CAD), and stroke.

Methods

This retrospective cohort study evaluated 7063 individuals for CVD, CAD, and stroke events in a 10-year follow-up. The participants were divided into four groups depending on whether they had DM or depression. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for demographic, lifestyle, and clinical covariates. Additive interaction was evaluated using the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).

Results

Total cardiovascular events were 830. Participants with both DM and depression had the highest risk of all cardiovascular outcomes. Compared with participants with neither condition, adjusted HRs were 2.93 for CVD, 2.85 for CAD, and 4.85 for stroke. While depression alone was not significantly associated with stroke, the coexistence of DM and depression was associated with more than a twofold higher risk of stroke compared with DM alone. Additive interaction analysis demonstrated a significant positive interaction for stroke (RERI = 2.084, AP = 0.430, S = 2.183), whereas no significant interaction was observed for CVD or CAD.

Conclusion

The coexistence of DM and depression was associated with significantly increased risks of CVD, CAD, and stroke. A significant synergistic effect was observed specifically for stroke, suggesting that depression may amplify the cerebrovascular consequences of DM.

Graphical abstract