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The familial and genetic contribution to the association between depression and cardiovascular disease: a twin cohort study

Molecular Psychiatry volume 26, pages 4245–4253 (2021)Cite this article

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Abstract

Depression and cardiovascular disease (ischemic heart disease and stroke) are associated in a bidirectional manner. Their relatively high heritability has led to the hypothesis that this co-occurrence is related to shared familial and genetic factors; this study aims to test this hypothesis. We included 23,498 monozygotic and 39,540 same-sex dizygotic twins from the Danish Twin Registry followed from January 1977 until December 2011 in nationwide Danish registries. We used survival analyses accounting for censoring and competing risk of death to estimate cumulative incidence, casewise concordance, relative recurrence risk, and heritability of the co-occurrence of depression and cardiovascular disease by age using monozygotic and same-sex dizygotic twin pairs. The casewise concordance of ischemic heart disease or stroke in twins whose co-twin was diagnosed with depression was at all ages similar for the monozygotic and dizygotic twin pairs and to the cumulative incidence of ischemic heart disease or stroke, respectively, in the entire twin population. A similar pattern was seen in analyses of depression risk given the co-twin being diagnosed with ischemic heart disease or stroke. Relative recurrence risk and heritability estimates were also of modest size and with confidence intervals including unity. Results were similar after stratification by gender as well as when redefining depression to include the use of antidepressant medication from 1995. Our findings do not support that co-occurrence between depression and cardiovascular disease is explainable by shared genetic factors, nor did we find strong evidence of a familial effect.

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Fig. 1: Risk of ischemic heart disease or stroke if co-twin was diagnosed with depression.
Fig. 2: Risk of depression if co-twin was diagnosed with ischemic heart disease or stroke.
Fig. 3: Relative recurrence risk ratio of depression, ischemic heart disease and stroke.

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Data availability

The data that support the findings of this study are available from Statistics Denmark. Restrictions apply to the availability of the data that were used under license for this study. Data are available from Statistics Denmark with the permission of the scientific board of the Danish Twin Registry.

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Acknowledgements

This work was supported by the Lundbeck Foundation, the Danish Heart Foundation, Eva and Henry Frænkels Mindelegat, and the Independent Research Fund Denmark.

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Authors and Affiliations

  1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg F, Denmark

    Marie Kim Wium-Andersen, Ida Kim Wium-Andersen & Merete Osler

  2. Department of Epidemiology, Biostatistics, and Biodemography, Institute of Public Health, University of Southern Denmark and the Danish Twin Registry, University of Southern Denmark, J B Winsløw Parken 9, 5000, Odense, Denmark

    Martin Dalgaard Villumsen, Jacob von Bornemann Hjelmborg & Kaare Christensen

  3. Psychiatric Center Copenhagen, Rigshospital, Edel Sauntes Allé 10, 2100, Copenhagen Ø, Denmark

    Ida Kim Wium-Andersen & Martin Balslev Jørgensen

  4. Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3, 2200, Copehagen N, Denmark

    Martin Balslev Jørgensen

  5. Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farigmagsgade 5, 1014, Copenhagen K, Denmark

    Merete Osler

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  1. Marie Kim Wium-Andersen
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Correspondence to Merete Osler.

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Wium-Andersen, M.K., Villumsen, M.D., Wium-Andersen, I.K. et al. The familial and genetic contribution to the association between depression and cardiovascular disease: a twin cohort study. Mol Psychiatry 26, 4245–4253 (2021). https://doi.org/10.1038/s41380-020-00954-6

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