Depression and Anxiety Symptoms and Coronary Risk Factors 169 169 Tohoku J. Exp. Med., 2007, 212, 169-175 Received January 10, 2007; revision accepted for publication April 25, 2007. Correspondence: Mutlu Vural, Bayar cad. Pinar sok. Catalpinar sitesi, B blok 8/27 Kozyatagi 34742, Kadikoy/ Istanbul, Turkey. e-mail: heppikalp@yahoo.com, mutluvural74@mynet.com Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain MUTLU VURAL, 1 ÖMER ¸ SATIROĞLU, 1 BERFU AKBAS ¸, 2 IS ¸IN GÖKSEL 3 and ÖCAL KARABAY 4 1 Avrupa Safak Hospital Cardiology Clinics, Istanbul, Turkey 2 Psychiatry Department, Yeditepe University School of Medicine, Istanbul, Turkey 3 Avrupa Safak Hospital Psychiatry Clinics, Istanbul, Turkey 4 Avrasya Hospital, Cardiology Clinics, Istanbul, Turkey VURAL, M., S ¸ATIROĞLU, O., AKBAS ¸, B., GÖKSEL, I. and KARABAY, O. Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain. Tohoku J. Exp. Med., 2007, 212 (2), 169-175 ── Psychologi- cal variables, such as depression and anxiety, are known as independent risk factors for coronary artery disease (CAD), suggesting the interaction of psychological and physiologi- cal factors in the development of CAD. In the present study, we analyzed the possible association between depressive and anxiety symptoms and major atherosclerotic risk fac- tors in patients with chest pain warranting coronary angiography. The patients without CAD (n = 159) and those with CAD (n = 155) were evaluated for the severity of depres- sion and anxiety by the symptom scales; high scores indicate severe symptoms. Age, male/female ratio, prevalence of diabetes mellitus (DM), and depression level were signif- cantly higher in the CAD group. Among a total of 314 patients with chest pain, the mean depression score was higher in patients with DM (16.01 ± 8.12 vs 13.01 ± 9.6, p = 0.01) and those with hypercholesterolemia (15.43 ± 9.61 vs 12.53 ± 9.61, p = 0.02). The mean anxiety score was also higher in patients with DM (20.81 ± 12.85 vs 16.51 ± 12.09, p = 0.008), hypercholesterolemia (20.67 ± 13.11 vs 15.29 ± 11.36, p = 0.002), or hypertension (20.74 ± 12.94 vs 14.1 ± 10.8, p = 0.001). Thus, DM and hypercholesterolemia are associ- ated with depression and anxiety, while hypertension is only related to anxiety. In contrast, smoking and family history of atherosclerosis are not related to depression and anxiety scores. These results suggest depression and anxiety symptoms may contribute to the development and progression of CAD, especially in patients with DM or hypercholesterol- emia. ──── depression; anxiety; psychological tests; atherosclerosis risk factors; coro- nary artery disease © 2007 Tohoku University Medical Press In large-scale and prospective follow-up studies, depression was shown to be an indepen- dent risk factor for myocardial infarction and car- diovascular mortality (Ariyo et al. 2000; Ferketich et al. 2000). Anxiety disorders were also associ- ated with accelerated coronary artery disease