Treating the patient not just the disease? : Delving deeper into the possible link between affective disorders and coronary heart disease through statistical analysis of a random sample of Maltese people

Abstract

Background: Ischemic heart disease is the leading cause of death in Males in Malta and globally. Affective disorders are the commonest psychological problem. This cross-sectional study utilizes a multiple regression model utilizing binary logistic to delve deeper into the link between affective disorders and coronary heart disease and also the link between coronary heart disease and anxiety and depression separately. Methods: The study was performed in the small Mediterranean island of Malta through the European health interview survey (EHIS), at a national level involving 5500 participants. The response rate attained in the actual field work was 72%. Statistical analysis involved performing chi-squared tests on all contributing variables and retaining those variables that were significant to both diseases. These were then placed in a multiple regression model using forward stepwise binary logistic to retain only the most significant variables. Results: Age, gender, BMI, diabetes prevalence, depression prevalence, anxiety prevalence, hypertension prevalence, affective disorders( having either anxiety or depression), smoking status, frequency of alcohol intake, and educational level all had a significance of <0.05, some; than less than 0.01. On fitting a multiple regression model, Anxiety (p=0.033), age (p=<0.001), gender (p=<0.001), hypertension (p=0.016) retained their significance in the model. Diabetes could not be analyzed due to power issues. Conclusion: BMI was not retained in the model having been replaced by associated conditions such as hypertension, together with age and gender as strongly associated risk factors. Anxiety nevertheless retained its independent association with coronary heart disease, in spite of the presence of the other stronger predictors described above.