The Role of Stress and Inflammation in Depression in Hispanics with Chronic Heart Failure

Introduction: Depression is a common comorbidity in heart failure (HF) and is commonly associated with increased inflammation leading to poor outcomes. Low socioeconomic status (SES) and stress are common in Hispanics but have not adequately been described in those with HF.  The purpose of this exploratory study was to examine depression and its relationship with socioeconomic status, stress, and inflammation in Hispanics with HF.  
Methods: 55 patients (71.62+/-11.33; 74.5% male; 31% Hispanic) with HF were assessed for their perceived stress (PS) using PSS, CRP serum levels, and education level and yearly income as indices of SES.  Descriptive data and t-test and chi-square were used to compare Hispanics and non-Hispanic Whites (NHW) on sociodemographic and clinical characteristics and linear multiple regression to assess the relationship between depression, ethnicity, PS, CRP, and SES. 
Results: Hispanics were younger and had lower education and income levels than NHW. No significant difference was found between both groups in depression and stress scores, and CRP levels. Independent of age, gender, NYHA class, BMI, education levels, and perceived stress (B=0.39, p=0.009) and marital status (B=0.37, p=0.049) predicted depression scores. When yearly income replaced education level in the multiple regression model, only PS (B=0.43, p=0.003) predicted depression. Hispanic ethnicity and CRP did not contribute to the variation of depression in both models.
Conclusion: This study shows the importance of stress in depression. Sources of stress in HF should be further explored to develop interventions that effectively reduce stress regardless of patient’s et