{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T19:47:55Z","timestamp":1767642475117,"version":"3.48.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chronic Stress"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular diseases (CVD) and depression are growing global health concerns as heart attack and stroke solely account for around 85% of total CVD deaths and 280 million ie, while 3.4% of the world's population have depression. A bi-directional relationship exists between depression and heart disease: about one-fourth of heart disease patients experience depression, and those with depression have a higher risk of developing heart disease compared to the general population. This study aims to examine the association between depression and heart attack as a dependent variable, focusing on demographic and behavioral correlates of individuals in Tennessee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cross-sectional analysis using the 2022 Behavior Risk Factor Surveillance System (BRFSS) data for Tennessee (N\u2009=\u20095266). Our analytical approaches involved descriptive and multivariate analysis (logistic regression analysis) to assess the association between depression and heart attack in Tennessee. The primary dependent variable of interest was a self-reported lifetime heart attack and independent variables included self-reported lifetime depression, no exercise in the past 30 days, smoking status, race\/ethnicity, gender, and age category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7.5% (N\u2009=\u2009731) of participants reported lifetime heart attack and 27.8% (N\u2009=\u2009828) of participants reported depression. Depression was found to be significantly associated with higher odds of a heart attack (AOR = 1.36; 95% CI, 1.06, 1.73), p\u2009&lt;\u20090.001). Similarly, no exercise in the past 30 days (AOR = 1.74; 95% CI, 1.39, 2.20, p\u2009&lt;\u20090.001) was also associated with higher odds of a heart attack. Furthermore, low income, current smoking status, and race\/ethnicity were not found to be significantly associated with heart attack in our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reinforces the significant link between depression and heart attack while highlighting the complex interplay of demographic and behavioral factors influencing onset of cardiovascular diseases. The findings underscore the necessity for a comprehensive approach to cardiovascular health that integrates mental health considerations and addresses broader social determinants of health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24705470251324781","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T16:08:41Z","timestamp":1742918921000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association between Depression and Heart Attack: Examining Demographic and Behavioral Correlates in Tennessee"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3446-9216","authenticated-orcid":false,"given":"Manik","family":"Ahuja","sequence":"first","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achala","family":"Ghimire","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-8246","authenticated-orcid":false,"given":"Kajol","family":"Dahal","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Adebayo-Abikoye","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadii","family":"Mamudu","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7562-9219","authenticated-orcid":false,"given":"Jeetendra","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"McKenzie","family":"Dooley","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiveya","family":"Sathiyaseelan","sequence":"additional","affiliation":[{"name":"Wellmont Health System LPH Family Medicine Residency Program, Ballad Health, Big Stone Gap, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chukwubuikem James","family":"Arize","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Cimilluca","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Keaton","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4154-2459","authenticated-orcid":false,"given":"Jennifer S.","family":"Tinman","sequence":"additional","affiliation":[{"name":"University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5530-8239","authenticated-orcid":false,"given":"Rhonda","family":"Williams","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Hasan","sequence":"additional","affiliation":[{"name":"East Tennessee State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen","family":"Fernandopulle","sequence":"additional","affiliation":[{"name":"East Tennessee State University"},{"name":"Department of Psychiatry, James H. Quillen Department of Veterans Affairs Medical Center. Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2016.10.024"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd19.220347"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2018.20.1\/mdehert"},{"issue":"1","key":"e_1_3_2_5_2","first-page":"49","article-title":"Reducing the global burden of depression","volume":"4","author":"Chahil PK","year":"2014","unstructured":"Chahil PK. Reducing the global burden of depression. Revue interdisciplinaire des sciences de la sant\u00e9 - Interdiscip J Health Sci. 2014;4(1):49. doi:https:\/\/doi.org\/10.18192\/RISS-IJHS.V4I1.1221","journal-title":"Revue interdisciplinaire des sciences de la sant\u00e9 - Interdiscip J Health Sci"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2019.08.002"},{"issue":"3","key":"e_1_3_2_7_2","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.028332","article-title":"Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States","volume":"12","author":"Kwapong YA","year":"2023","unstructured":"Kwapong YA, Boakye E, Khan SS, et al. Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States. J Am Heart Assoc. 2023;12(3): e028332. doi:https:\/\/doi.org\/10.1161\/JAHA.122.028332","journal-title":"J Am Heart Assoc"},{"issue":"25","key":"e_1_3_2_8_2","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCULATIONAHA.110.017285","article-title":"Depression after heart attack: Why should i be concerned about depression after a heart attack?","volume":"123","author":"Williams RB","year":"2011","unstructured":"Williams RB. Depression after heart attack: Why should i be concerned about depression after a heart attack? Circulation. 2011;123(25):e639\u2013e640. doi:https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.110.017285","journal-title":"Circulation"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.5114\/hpr.2020.95910"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1353\/dem.2007.0004"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956797614551750"},{"issue":"1","key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-018-1977-3","article-title":"Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago","volume":"19","author":"Bahall M","year":"2019","unstructured":"Bahall M. Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatry. 2019;19(1):1\u201311. doi:https:\/\/doi.org\/10.1186\/S12888-018-1977-3\/TABLES\/2","journal-title":"BMC Psychiatry"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0b013e31820e8106"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000102"},{"key":"e_1_3_2_15_2","unstructured":"NIMH\u202f\u00bb Major Depression. Accessed August 22 2023. https:\/\/www.nimh.nih.gov\/health\/statistics\/major-depression."},{"key":"e_1_3_2_16_2","unstructured":"Depression Among Women | CDC. Accessed August 20 2023. https:\/\/www.cdc.gov\/reproductivehealth\/depression\/index.htm#Depression."},{"issue":"10","key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"6227","DOI":"10.3390\/ijerph19106227","article-title":"Citation: Zare, H how income and income inequality drive depressive symptoms in U.S. adults, does sex matter: 2005-2016","volume":"19","author":"Zare H","year":"2022","unstructured":"Zare H, Meyerson NS, Adania Nwankwo C, Thorpe RJ. Citation: Zare, H how income and income inequality drive depressive symptoms in U.S. adults, does sex matter: 2005-2016. Int J Environ Res Public Health. 2022;19(10):6227\u201362016. doi:https:\/\/doi.org\/10.3390\/ijerph19106227","journal-title":"Int J Environ Res Public Health"},{"key":"e_1_3_2_18_2","unstructured":"Heart Disease Still Tennessee\u2019s Top Cause of Death 2017. www.heart.org\/HEARTORG\/"},{"key":"e_1_3_2_19_2","unstructured":"Mental Health in Tennessee. Accessed August 22 2023. https:\/\/www.nami.org\/NAMI\/media\/NAMI-Media\/StateFactSheets\/TennesseeStateFactSheet.pdf."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-021-01019-4"},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijcard.2022.05.056","article-title":"Depression and ischemic heart disease","volume":"364","author":"Pivato CA","year":"2022","unstructured":"Pivato CA, Chandiramani R, Petrovic M, et al. Depression and ischemic heart disease. Int J Cardiol. 2022;364:9\u201315. doi:https:\/\/doi.org\/10.1016\/j.ijcard.2022.05.056","journal-title":"Int J Cardiol"},{"issue":"3","key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s11920-010-0116-8","article-title":"The impact of depression in heart disease","volume":"12","author":"Sher Y","year":"2010","unstructured":"Sher Y, Lolak S, Maldonado JR. The impact of depression in heart disease. Curr Psychiatry Rep. 2010;12(3):255\u2013264. doi:https:\/\/doi.org\/10.1007\/s11920-010-0116-8","journal-title":"Curr Psychiatry Rep"},{"issue":"1","key":"e_1_3_2_23_2","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3949\/ccjm.75a.08011","article-title":"Depression and heart disease: What do we know, and where are we headed?","volume":"76","author":"Pozuelo L","year":"2009","unstructured":"Pozuelo L, Tesar G, Zhang J, Penn M, Franco K, Jiang W. Depression and heart disease: What do we know, and where are we headed? Cleve Clin J Med. 2009;76(1):59\u201370. doi:https:\/\/doi.org\/10.3949\/ccjm.75a.08011","journal-title":"Cleve Clin J Med"},{"issue":"6","key":"e_1_3_2_24_2","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.mcna.2004.06.007","article-title":"Smoking and depression","volume":"88","author":"Paperwalla KN","year":"2004","unstructured":"Paperwalla KN, Levin TT, Weiner J, Saravay SM. Smoking and depression. Med Clin N Am. 2004;88(6):1483\u20131494. doi:https:\/\/doi.org\/10.1016\/j.mcna.2004.06.007","journal-title":"Med Clin N Am."},{"issue":"1","key":"e_1_3_2_25_2","doi-asserted-by":"crossref","DOI":"10.1186\/s13690-020-00463-6","article-title":"Obesity, food insecurity, and depression among females","volume":"78","author":"Ahuja M","year":"2020","unstructured":"Ahuja M, Sathiyaseelan T, Wani RJ, Fernandopulle P. Obesity, food insecurity, and depression among females. Arch Public Health. 2020;78(1):1483\u2013xi. doi:https:\/\/doi.org\/10.1186\/s13690-020-00463-6","journal-title":"Arch Public Health."},{"issue":"3","key":"e_1_3_2_26_2","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S0006-3223(03)00608-5","article-title":"Depression and obesity","volume":"54","author":"Stunkard AJ","year":"2003","unstructured":"Stunkard AJ, Faith MS, Allison KC. Depression and obesity. Biol Psychiatry. 2003;54(3):330\u2013337. doi:https:\/\/doi.org\/10.1016\/S0006-3223(03)00608-5","journal-title":"Biol Psychiatry"},{"issue":"4","key":"e_1_3_2_27_2","first-page":"1105","article-title":"Cardiac system during the aging process","volume":"14","author":"Ribeiro ASF","year":"2023","unstructured":"Ribeiro ASF, Zerolo BE, L\u00f3pez-Espuela F, S\u00e1nchez R, Fernandes VS. Cardiac system during the aging process. Aging Dis. 2023;14(4):1105\u20131122. doi:https:\/\/doi.org\/10.14336\/AD.2023.0115","journal-title":"Aging Dis"},{"issue":"2","key":"e_1_3_2_28_2","article-title":"Gender bias in diagnosis, prevention, and treatment of cardiovascular diseases: A systematic review","volume":"16","author":"Al Hamid A","year":"2024","unstructured":"Al Hamid A, Beckett R, Wilson M, et al. Gender bias in diagnosis, prevention, and treatment of cardiovascular diseases: A systematic review. Cureus. 2024;16(2):e54264. doi:https:\/\/doi.org\/10.7759\/cureus.54264","journal-title":"Cureus"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"issue":"10075","key":"e_1_3_2_30_2","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/S0140-6736(16)32380-7","article-title":"Socioeconomic status and the 25\u00d725 risk factors as determinants of premature mortality: A multicohort study and meta-analysis of 1\u00b77 million men and women","volume":"389","author":"Stringhini S","year":"2017","unstructured":"Stringhini S, Carmeli C, Jokela M, et al. Socioeconomic status and the 25\u00d725 risk factors as determinants of premature mortality: A multicohort study and meta-analysis of 1\u00b77 million men and women. Lancet. 2017;389(10075):1229\u20131237. doi:https:\/\/doi.org\/10.1016\/S0140-6736(16)32380-7","journal-title":"Lancet"},{"issue":"1","key":"e_1_3_2_31_2","article-title":"Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods","volume":"20","author":"Gary-Webb TL","year":"2020","unstructured":"Gary-Webb TL, Egnot NS, Nugroho A, Dubowitz T, Troxel WM. Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods. BMC Public Health. 2020;20(1):52. doi:https:\/\/doi.org\/10.1186\/s12889-019-8119-9","journal-title":"BMC Public Health"},{"issue":"3","key":"e_1_3_2_32_2","first-page":"258","article-title":"Racial and ethnic disparities in cardiovascular disease - analysis across major US national databases","volume":"116","author":"Minhas AMK","year":"2024","unstructured":"Minhas AMK, Talha KM, Abramov D, et al. Racial and ethnic disparities in cardiovascular disease - analysis across major US national databases. J Natl Med Assoc. 2024;116(3):258\u2013270. doi:https:\/\/doi.org\/10.1016\/J.JNMA.2024.01.022","journal-title":"J Natl Med Assoc"},{"issue":"9","key":"e_1_3_2_33_2","article-title":"Trends in racial\/ethnic disparities in cardiovascular health among US adults from 1999\u20132012","volume":"6","author":"Pool LR","year":"2017","unstructured":"Pool LR, Ning H, Lloyd-Jones DM, Allen NB. Trends in racial\/ethnic disparities in cardiovascular health among US adults from 1999\u20132012. J Am Heart Assoc. 2017;6(9):e006027. doi:https:\/\/doi.org\/10.1161\/JAHA.117.006027","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"e_1_3_2_34_2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.amjcard.2013.08.042","article-title":"Impact of metabolic syndrome on the risk of cardiovascular disease mortality in the United States and in Japan","volume":"113","author":"Liu L","year":"2014","unstructured":"Liu L, Miura K, Fujiyoshi A, et al. Impact of metabolic syndrome on the risk of cardiovascular disease mortality in the United States and in Japan. Am J Cardiol. 2014;113(1):84\u201389. doi:https:\/\/doi.org\/10.1016\/j.amjcard.2013.08.042","journal-title":"Am J Cardiol."},{"issue":"1","key":"e_1_3_2_35_2","article-title":"Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors","volume":"20","author":"Ho FK","year":"2022","unstructured":"Ho FK, Gray SR, Welsh P, et al. Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors. BMC Med. 2022;20(1):149. doi:https:\/\/doi.org\/10.1186\/s12916-022-02337-w","journal-title":"BMC Med"},{"issue":"4","key":"e_1_3_2_36_2","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s11357-023-00793-7","article-title":"Longitudinal lipidomic signatures of all-cause and CVD mortality in American Indians: Findings from the strong heart study","volume":"45","author":"Miao G","year":"2023","unstructured":"Miao G, Fiehn O, Malloy KM, et al. Longitudinal lipidomic signatures of all-cause and CVD mortality in American Indians: Findings from the strong heart study. Geroscience. 2023;45(4):2669\u20132687. doi:https:\/\/doi.org\/10.1007\/s11357-023-00793-7","journal-title":"Geroscience"},{"issue":"1","key":"e_1_3_2_37_2","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.017044","article-title":"Association between silent myocardial infarction and long-term risk of sudden cardiac death","volume":"10","author":"Cheng YJ","year":"2021","unstructured":"Cheng YJ, Jia YH, Yao FJ, et al. Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021;10(1). doi:https:\/\/doi.org\/10.1161\/JAHA.120.017044","journal-title":"J Am Heart Assoc"}],"container-title":["Chronic Stress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24705470251324781","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24705470251324781","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24705470251324781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T16:37:58Z","timestamp":1767631078000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24705470251324781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":36,"alternative-id":["10.1177\/24705470251324781"],"URL":"https:\/\/doi.org\/10.1177\/24705470251324781","relation":{},"ISSN":["2470-5470","2470-5470"],"issn-type":[{"type":"print","value":"2470-5470"},{"type":"electronic","value":"2470-5470"}],"subject":[],"published":{"date-parts":[[2025,3,25]]},"article-number":"24705470251324781"}}