Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales

Ellins, Libby; Summers, Richard; John, Ann; J, David P; Lloyd, Keith; Akbari, Ashley; Gravenor, Michael; Halcox, Julian

doi:10.1093/eurjpc/zwaf178

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Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales

Libby Ellins

, Richard Summers, Ann John

, David P J Osborn, Keith Lloyd

, Ashley Akbari

, Michael Gravenor

, Julian Halcox

European Journal of Preventive Cardiology, Start page: zwaf178

Swansea University Authors: Libby Ellins , Richard Summers, Ann John , Keith Lloyd , Ashley Akbari , Michael Gravenor , Julian Halcox

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© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.
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DOI (Published version): 10.1093/eurjpc/zwaf178

Abstract

Aims: To investigate rates of cardiovascular risk factor assessment (blood pressure, lipid, and QRISK score) in routine clinical practice for primary prevention of cardiovascular disease in patients with and without depression. Methods and results: A retrospective observational cohort study using el...

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Published in:	European Journal of Preventive Cardiology
ISSN:	2047-4873 2047-4881
Published:	Oxford University Press (OUP) 2025
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa69153

first_indexed	2025-03-26T11:37:51Z
last_indexed	2025-11-18T09:32:48Z
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Methods and results: A retrospective observational cohort study using electronic health record data sources was carried out. Rates of blood pressure measurement, lipid checks, and QRISK documentation in primary care were calculated for non-depressed, and patients prior and subsequent to depression diagnosis. Poisson regression adjusting for age and sex was used to explore associations between depression status and rate of assessment. Differences in rates of assessment by deprivation and location of residence (urban/rural) were also explored. Of 2 290 075 patients, 176 062 had depression diagnosed. Patients with depression had blood pressure and lipid levels checked and QRISK score documented more frequently, after adjustment for sex and age group. Sex differences were noted, with younger females more likely to have blood pressure assessment and males more likely to have lipid levels checked, irrespective of depression status. There were significant three-way interactions between depression ∗ sex ∗ age group for all outcomes, with sex difference in blood pressure assessment highly dependent on age, and sex/depression status difference in lipid assessment most notable in the 60–74 age group. Conclusion:Patients with depression are more likely to have their blood pressure, lipid levels, and QRISK documented than patients without depression. 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spelling	2025-11-17T13:53:26.0561900 v2 69153 2025-03-26 Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false af4f85a1e7cc0ac847aa17ec0824384a Richard Summers Richard Summers true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false a13aaa0df9045c205e82ed3b95d18c10 0000-0002-1440-4124 Keith Lloyd Keith Lloyd true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 70a544476ce62ba78502ce463c2500d6 0000-0003-0710-0947 Michael Gravenor Michael Gravenor true false 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 2025-03-26 MEDS Aims: To investigate rates of cardiovascular risk factor assessment (blood pressure, lipid, and QRISK score) in routine clinical practice for primary prevention of cardiovascular disease in patients with and without depression. Methods and results: A retrospective observational cohort study using electronic health record data sources was carried out. Rates of blood pressure measurement, lipid checks, and QRISK documentation in primary care were calculated for non-depressed, and patients prior and subsequent to depression diagnosis. Poisson regression adjusting for age and sex was used to explore associations between depression status and rate of assessment. Differences in rates of assessment by deprivation and location of residence (urban/rural) were also explored. Of 2 290 075 patients, 176 062 had depression diagnosed. Patients with depression had blood pressure and lipid levels checked and QRISK score documented more frequently, after adjustment for sex and age group. Sex differences were noted, with younger females more likely to have blood pressure assessment and males more likely to have lipid levels checked, irrespective of depression status. There were significant three-way interactions between depression ∗ sex ∗ age group for all outcomes, with sex difference in blood pressure assessment highly dependent on age, and sex/depression status difference in lipid assessment most notable in the 60–74 age group. Conclusion:Patients with depression are more likely to have their blood pressure, lipid levels, and QRISK documented than patients without depression. Sex differences in assessment of blood pressure and lipid assessments may also impact on future cardiovascular risk management, providing opportunities for potential improvements in assessment of risk factors. Journal Article European Journal of Preventive Cardiology 0 zwaf178 Oxford University Press (OUP) 2047-4873 2047-4881 Depression, Risk factors, Blood pressure, Lipids, Cardiovascular disease 26 3 2025 2025-03-26 10.1093/eurjpc/zwaf178 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) The study was funded by the British Heart Foundation Project Grant ref. PG/21/10631. 2025-11-17T13:53:26.0561900 2025-03-26T11:36:26.5497585 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Libby Ellins 0000-0001-5164-6416 1 Richard Summers 2 Ann John 0000-0002-5657-6995 3 David P J Osborn 4 Keith Lloyd 0000-0002-1440-4124 5 Ashley Akbari 0000-0003-0814-0801 6 Michael Gravenor 0000-0003-0710-0947 7 Julian Halcox 0000-0001-6926-2947 8 69153__33960__bbe55eefa655447f8fdff9f61342115d.pdf 69153.AAM.pdf 2025-04-07T10:32:10.9924153 Output 970730 application/pdf Accepted Manuscript true © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. true eng https://creativecommons.org/licenses/by/4.0/
title	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
spellingShingle	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales Libby Ellins Richard Summers Ann John Keith Lloyd Ashley Akbari Michael Gravenor Julian Halcox
title_short	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
title_full	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
title_fullStr	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
title_full_unstemmed	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
title_sort	Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales
author_id_str_mv	553ce2abe05a6396e7dd6eadb6b90a6d af4f85a1e7cc0ac847aa17ec0824384a ed8a9c37bd7b7235b762d941ef18ee55 a13aaa0df9045c205e82ed3b95d18c10 aa1b025ec0243f708bb5eb0a93d6fb52 70a544476ce62ba78502ce463c2500d6 3676f695eeda169d0f8c618adf27c04b
author_id_fullname_str_mv	553ce2abe05a6396e7dd6eadb6b90a6d_*_Libby Ellins af4f85a1e7cc0ac847aa17ec0824384a__Richard Summers ed8a9c37bd7b7235b762d941ef18ee55__Ann John a13aaa0df9045c205e82ed3b95d18c10__Keith Lloyd aa1b025ec0243f708bb5eb0a93d6fb52__Ashley Akbari 70a544476ce62ba78502ce463c2500d6__Michael Gravenor 3676f695eeda169d0f8c618adf27c04b_**_Julian Halcox
author	Libby Ellins Richard Summers Ann John Keith Lloyd Ashley Akbari Michael Gravenor Julian Halcox
author2	Libby Ellins Richard Summers Ann John David P J Osborn Keith Lloyd Ashley Akbari Michael Gravenor Julian Halcox
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container_title	European Journal of Preventive Cardiology
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doi_str_mv	10.1093/eurjpc/zwaf178
publisher	Oxford University Press (OUP)
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description	Aims: To investigate rates of cardiovascular risk factor assessment (blood pressure, lipid, and QRISK score) in routine clinical practice for primary prevention of cardiovascular disease in patients with and without depression. Methods and results: A retrospective observational cohort study using electronic health record data sources was carried out. Rates of blood pressure measurement, lipid checks, and QRISK documentation in primary care were calculated for non-depressed, and patients prior and subsequent to depression diagnosis. Poisson regression adjusting for age and sex was used to explore associations between depression status and rate of assessment. Differences in rates of assessment by deprivation and location of residence (urban/rural) were also explored. Of 2 290 075 patients, 176 062 had depression diagnosed. Patients with depression had blood pressure and lipid levels checked and QRISK score documented more frequently, after adjustment for sex and age group. Sex differences were noted, with younger females more likely to have blood pressure assessment and males more likely to have lipid levels checked, irrespective of depression status. There were significant three-way interactions between depression ∗ sex ∗ age group for all outcomes, with sex difference in blood pressure assessment highly dependent on age, and sex/depression status difference in lipid assessment most notable in the 60–74 age group. Conclusion:Patients with depression are more likely to have their blood pressure, lipid levels, and QRISK documented than patients without depression. Sex differences in assessment of blood pressure and lipid assessments may also impact on future cardiovascular risk management, providing opportunities for potential improvements in assessment of risk factors.
published_date	2025-03-26T05:27:26Z
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Cardiovascular risk assessment in male and female patients with and without depression: an electronic health record evaluation in Wales

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