Depression is a common and serious mental illness that begins early in life. An association between cardiovascular disease (CVD) and subsequent depression is clear in adults. We examined associations between individual CVD risk factors and depression in young people.

We searched MEDLINE, EMBASE, and PsycINFO databases from inception to 1 January 2020. We extracted data from cohort studies assessing the longitudinal association between CVD risk factors [body mass index (BMI), smoking, systolic blood pressure (SBP), total cholesterol, high-density lipoprotein] and depression, measured using a validated tool in individuals with mean age of 24 years or younger. Random effect meta-analysis was used to combine effect estimates from individual studies, including odds ratio (OR) for depression and standardised mean difference for depressive symptoms.

Based on meta-analysis of seven studies, comprising 15 753 participants, high BMI was associated with subsequent depression [pooled OR 1.61; 95% confidence interval (CI) 1.21–2.14; I2 = 31%]. Based on meta-analysis of eight studies, comprising 30 539 participants, smoking was associated with subsequent depression (pooled OR 1.73; 95% CI 1.36–2.20; I2 = 74%). Low, but not high, SBP was associated with an increased risk of depression (pooled OR 3.32; 95% CI 1.68–6.55; I2 = 0%), although this was based on a small pooled high-risk sample of 893 participants. Generalisability may be limited as most studies were based in North America or Europe.

Targeting childhood/adolescent smoking and obesity may be important for the prevention of both CVD and depression across the lifespan. Further research on other CVD risk factors including blood pressure and cholesterol in young people is required.

抑郁症是一种常见且严重的精神疾病，始于生命早期。在成年人中，心血管疾病（CVD）与随后的抑郁症之间的关联是显而易见的。我们研究了个体心血管疾病危险因素与年轻人抑郁症之间的关联。

我们检索了从一开始到 2020 年 1 月 1 日的 MEDLINE、EMBASE 和 PsycINFO 数据库。我们从评估 CVD 危险因素 [体重指数 (BMI)、吸烟、收缩压 (SBP)、总胆固醇、高密度脂蛋白]和抑郁症，使用经过验证的工具对平均年龄为 24 岁或以下的个体进行测量。随机效应荟萃分析用于结合各个研究的效应估计，包括抑郁症的比值比 (OR) 和抑郁症状的标准化平均差。

根据对 15 753 名参与者的七项研究的荟萃分析，高 BMI 与随后的抑郁症相关[汇总 OR 1.61； 95% 置信区间 (CI) 1.21–2.14； I 2 = 31%]。根据对 30 539 名参与者的八项研究的荟萃分析，吸烟与随后的抑郁症相关（汇总 OR 1.73；95% CI 1.36–2.20； I 2 = 74%）。低但不高的 SBP 与抑郁风险增加相关（汇总 OR 3.32；95% CI 1.68–6.55； I 2 = 0%），尽管这是基于 893 名参与者的小汇总高风险样本。由于大多数研究是在北美或欧洲进行的，因此普遍性可能受到限制。

针对儿童/青少年吸烟和肥胖可能对于一生中预防心血管疾病和抑郁症很重要。需要对年轻人的血压和胆固醇等其他心血管疾病危险因素进行进一步研究。