Table 3 Association between depressive symptoms and cardiovascular disease based on model 3 stratified by sex, age, BMI, race/ethnicity, educational level, marital status, smoking status, alcohol consumption, trouble sleeping, hypertension, diabetes, dyslipidemia, cancer, eGFR, PIR, HEI, and serum cotinine.

From: Factors influencing the association between depressive symptoms and cardiovascular disease in US population

Outcomes	Total	Cases	Depressive status				PHQ-9 as a continuous variable	P value for interaction
Outcomes	Total	Cases	No/Minimal	Mild	Moderate	Moderately severe/Severe	PHQ-9 as a continuous variable	P value for interaction
Sex
Male	5543	1073	1 [Ref]	1.09(0.73–1.64)	1.55(0.85–2.83)	1.32(0.74–2.37)	1.03(1.01–1.06)	0.009
P value				0.665	0.153	0.335	0.018
Female	5973	769	1 [Ref]	1.36(0.96–1.94)	2.24(1.24–4.07)	2.98(1.81–4.91)	1.07(1.05–1.10)
P value				0.083	0.009	< 0.001	< 0.001
Age
< 60	5562	402	1 [Ref]	1.19(0.79–1.79)	1.45(0.78–2.71)	2.06(1.18–3.60)	1.05(1.02–1.08)	0.858
P value				0.408	0.239	0.012	0.002
≥ 60	5954	1440	1 [Ref]	1.23(1.00–1.52)	2.58(1.30–5.15)	2.54(1.49–4.32)	1.07(1.04–1.09)
P value				0.048	0.008	< 0.001	< 0.001
BMI
< 30	6742	967	1 [Ref]	1.15(0.88–1.51)	2.50(0.99–6.31)	1.63(0.87–3.07)	1.06(1.02–1.09)	0.072
P value				0.291	0.053	0.124	< 0.001
≥ 30	4774	875	1 [Ref]	1.29(0.90–1.83)	1.61(1.01–2.56)	2.87(1.74–4.73)	1.06(1.03–1.08)
P value				0.158	0.046	< 0.001	< 0.001
White
Yes	5747	1090	1 [Ref]	1.26(0.97–1.64)	2.43(1.44–4.10)	2.38(1.37–4.13)	1.07(1.04–1.09)	0.600
P value				0.082	0.001	0.003	< 0.001
No	5769	752	1 [Ref]	1.21(0.85–1.71)	1.25(0.78–1.99)	2.21(1.34–3.64)	1.05(1.02–1.07)
P value				0.282	0.353	0.002	< 0.001
Education
Less than high school	2626	543	1 [Ref]	1.13(0.78–1.64)	1.76(1.15–2.70)	2.18(1.16–4.12)	1.06(1.03–1.09)	0.313
P value				0.520	0.010	0.017	< 0.001
at least high school	8890	1299	1 [Ref]	1.30(0.98–1.73)	2.12(1.20–3.72)	2.42(1.54–3.79)	1.06(1.04–1.08)
P value				0.069	0.010	< 0.001	< 0.001
Marital Status (Married)
Yes	6843	998	1 [Ref]	1.20(0.92–1.56)	1.74(1.01–2.99)	2.43(1.45–4.08)	1.06(1.03–1.08)	0.633
P value				0.169	0.047	0.001	< 0.001
No	4673	844	1 [Ref]	1.30(0.94–1.79)	2.27(1.21–4.27)	2.40(1.22–4.73)	1.06(1.03–1.10)
P value				0.106	0.012	0.012	< 0.001
Smoking
Yes	5589	1141	1 [Ref]	1.03(0.80–1.33)	1.49(0.90–2.46)	2.01(1.26–3.22)	1.04(1.02–1.06)	0.155
P value				0.825	0.120	0.004	< 0.001
No	5927	701	1 [Ref]	1.70(1.19–2.41)	3.51(1.48–8.34)	3.86(1.82–8.22)	1.10(1.06–1.15)
P value				0.004	0.005	< 0.001	< 0.001
Drink
Yes	8111	1291	1 [Ref]	1.09(0.85–1.41)	1.65(1.05–2.62)	2.40(1.42–4.04)	1.06(1.03–1.08)	0.596
P value				0.487	0.032	0.001	< 0.001
No	3405	551	1 [Ref]	1.63(1.10–2.43)	2.80(0.91–8.58)	2.14(1.03–4.46)	1.06(1.02–1.12)
P value				0.017	0.071	0.042	0.011
Trouble sleeping
Yes	3621	781	1 [Ref]	1.13(0.88–1.46)	1.68(1.10–2.57)	2.40(1.32–4.36)	1.05(1.02–1.08)	0.566
P value				0.333	0.018	0.005	< 0.001
No	7895	1061	1 [Ref]	1.35(0.94–1.94)	2.64(1.14–6.12)	2.13(1.04–4.39)	1.07(1.03–1.12)
P value				0.100	0.025	0.040	< 0.001
Cancer
Yes	1669	429	1 [Ref]	1.39(0.85–2.30)	1.64(0.81–3.35)	6.01(2.34–15.43)	1.09(1.04–1.14)	0.100
P value				0.188	0.167	< 0.001	< 0.001
No	9847	1413	1 [Ref]	1.20(0.98–1.48)	1.98(1.23–3.21)	2.00(1.33–3.01)	1.05(1.03–1.08)
P value				0.082	0.006	0.001	< 0.001
Hypertension
Yes	6636	1485	1 [Ref]	1.39(1.09–1.79)	1.75(1.16–2.64)	2.05(1.26–3.33)	1.06(1.04–1.08)	0.874
P value				0.010	0.008	0.005	< 0.001
No	4880	357	1 [Ref]	0.75(0.43–1.32)	2.55(1.00–6.51)	3.06(1.59–5.89)	1.06(1.02–1.10)
P value				0.310	0.049	0.001	0.004
Diabetes
Yes	2586	716	1 [Ref]	1.50(0.98–2.30)	1.93(1.14–3.25)	4.41(2.19–8.88)	1.08(1.05–1.12)	0.010
P value				0.062	0.015	< 0.001	< 0.001
No	8930	1126	1 [Ref]	1.16(0.90–1.49)	1.99(1.10–3.61)	1.87(1.11–3.17)	1.05(1.03–1.07)
P value				0.236	0.023	0.020	< 0.001
Dyslipidemia
Yes	9530	1621	1 [Ref]	1.17(0.92–1.50)	1.97(1.22–3.17)	2.34(1.47–3.70)	1.06(1.03–1.08)	0.650
P value				0.203	0.006	< 0.001	< 0.001
No	1986	221	1 [Ref]	1.92(1.22–3.04)	1.64(0.73–3.71)	3.15(1.07–9.27)	1.08(1.03–1.13)
P value				0.006	0.227	0.037	< 0.001
eGFR
< 60	1544	582	1 [Ref]	1.80(1.18–2.75)	1.50(0.78–2.91)	1.13(0.50–2.56)	1.05(1.02–1.09)	0.839
P value				0.007	0.221	0.758	0.004
≥ 60	9972	1260	1 [Ref]	1.10(0.83–1.46)	2.01(1.23–3.27)	2.76(1.87–4.08)	1.06(1.04–1.09)
P value				0.503	0.006	< 0.001	< 0.001
Family income level
Low and middle income	6696	1307	1 [Ref]	1.43(1.11–1.83)	2.06(1.27–3.34)	2.66(1.75–4.03)	1.07(1.05–1.09)	0.002
P value				0.006	0.004	< 0.001	< 0.001
High income	4820	535	1 [Ref]	0.88(0.59–1.30)	2.12(0.82–5.47)	0.93(0.20–4.39)	1.02(0.98–1.07)
P value				0.502	0.117	0.924	0.233
HEI score
< 50	4137	747	1 [Ref]	0.77(0.55–1.07)	2.01(1.08–3.74)	1.59(0.91–2.78)	1.04(1.01–1.08)	0.707
P value				0.120	0.029	0.102	0.014
≥ 50	7379	1095	1 [Ref]	1.66(1.26–2.19)	1.71(1.11–2.64)	3.50(1.90–6.46)	1.08(1.06–1.11)
P value				< 0.001	0.016	< 0.001	< 0.001

CVD, cardiovascular disease; Q, quartile; Ref, reference; PIR, family income-poverty ratio; BMI, body mass index; eGFR, estimated glomerular filtration rate; HEI, healthy eating index.
Model 3: adjustments for age, sex, race/ethnicity, education level, marital status, PIR, smoking status, alcohol consumption, BMI, HEI, disease histories (trouble sleeping, hypertension, diabetes, dyslipidemia, and cancer), blood pressure, glycohemoglobin, low-density lipoprotein, and eGFR.
P value for interaction: interaction of stratified variable and PHQ-9 score on CVD.
The white race was defined as non-Hispanic white. Low family income level is defined as PIR lower than 3.50. High family income level is defined as PIR of at least 3.50.

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