{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:20:44Z","timestamp":1791807644531,"version":"4.3.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371595"],"award-info":[{"award-number":["82371595"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences Innovation Fund","doi-asserted-by":"publisher","award":["2021-I2M-1-063"],"award-info":[{"award-number":["2021-I2M-1-063"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examines how changes in depressive symptoms influence cardiovascular disease (CVD) incidence in diverse ageing populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Data from four longitudinal cohorts were harmonized: China Health and Retirement Longitudinal Study (China), English Longitudinal Study of Ageing (UK), Health and Retirement Study (USA), and Mexican Health and Aging Study (Mexico). Depressive symptoms were assessed at baseline and follow-up using validated scales, and scores were standardized using z-scores. The primary outcome was incident CVD, defined as a composite of heart attack, angina, congestive heart failure, other physician-diagnosed heart conditions, and stroke. Cox proportional regression analyses assessed the associations between changes in depressive symptoms and CVD risk. Progression from no depression to mild depression was associated with a 28% increase in CVD risk (95% CI, 1.14\u20131.44), while progression to moderate-to-severe depression was associated with a 23% increase (95% CI, 1.04\u20131.46). Conversely, remission from mild depression to no depression significantly reduced CVD risk by 19% (95% CI, 0.68\u20130.98). Improvement from moderate-to-severe depression to mild depression decreased CVD risk by 25% (95% CI, 0.61\u20130.93), and remission from moderate-to-severe depression to no depression reduced it by 38% (95% CI, 0.50\u20130.76). Each 1-unit increase in the total depression score raised CVD risk by 12% (95% CI, 1.10\u20131.14), while each 1-unit increase in depression score change increased risk by 15% (95% CI, 1.11\u20131.19). Effects were stronger in participants aged &amp;lt;65 years than participants aged \u226565 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multinational cohort study demonstrates that worsening or progression of depressive symptoms increases CVD risk, while remission or improvement confers protective effects, highlighting the need to monitor depression symptom changes in CVD prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf586","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T12:07:01Z","timestamp":1758110821000},"source":"Crossref","is-referenced-by-count":18,"title":["Changes in depressive symptoms as predictors of incident cardiovascular disease: insights from four prospective cohorts"],"prefix":"10.1093","author":[{"given":"Shuang","family":"Wu","sequence":"first","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Yang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]},{"name":"Premium Care Center, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimeng","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyang","family":"Liang","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghui","family":"Shao","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167, Beilishi Road, Xicheng District, Beijing 100037 ,","place":["People\u2019s Republic of China"]},{"name":"National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyi","family":"Zhong","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , Nanchang, Jiangxi ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-8452","authenticated-orcid":false,"given":"Bi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University , Chongqing ,","place":["People\u2019s Republic of 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