Cardiovascular health and depressive symptoms in adolescence: findings from generation XXI cohort

Abstract Background Cardiovascular disease remains the leading cause of death globally. Growing evidence highlights the role of psychological health, particularly major depression, on cardiovascular outcomes, including cardiovascular health (CVH) decline and all-cause mortality. Adolescence is a critical period for both mental health and CVH. This study investigates the association between CVH and depressive symptoms in 13-year adolescents. Methods We conducted a cross-sectional analysis using data from 13-year-old participants of the Generation XXI birth cohort (Porto, Portugal). Adolescents with complete data on CVH and depressive symptoms were included. CVH was assessed using the Life's Essential 8 score; depressive symptoms were measured using the 13-item Beck Depression Inventory (BDI-13). Linear regression analyses were conducted, adjusting for maternal education and household income. Results Better cardiovascular health (higher scores) was associated with fewer reported depressive symptoms (B = -0.267, 95% CI: -0.439, -0.095) at the age of 13 years. After adjusting for maternal education and household income, the association remained (B = -0.301, 95% CI: -0.488; -0.114). Conclusions Better cardiovascular health in early adolescence is associated with lower depressive symptoms, even after adjustment for maternal education and household income. These findings support the integration of cardiovascular health promotion into adolescent mental health strategies. Public health actions could include enhancing school- and community-based programs that jointly target healthy behaviors and emotional well-being. Early, combined interventions may reduce long-term mental and cardiovascular health burdens. Promoting Life's Essential 8 framework in youth populations represents an innovative, feasible strategy to address intertwined physical and mental health disparities. Key messages • Better cardiovascular health in teens is linked to fewer depressive symptoms, highlighting the need for integrated public health strategies in adolescence. • Promoting Life’s Essential 8 in youth may improve both mental and cardiovascular health, reducing long-term health disparities from early life.