Depression and cardiovascular disease: Increasing evidence of a connection

Research output: Contribution to journalArticle

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Abstract

Cardiovascular disease (CVD) and major depression co-occur with far greater frequency than is generally recognized. Failure to diagnose major depression in patients with CVD may have a substantial detrimental effect on outcomes, given evidence from numerous studies suggesting that depression is an independent risk factor not only for the development of CVD, but also for death following myocardial infarction (MI). Extensive psychobiological research has revealed several pathophysiologic mechanisms that may contribute to the apparent vulnerability of depressed patients to CVD and to post-MI mortality. These mechanisms include increased sympathetic nervous system activity, reduced heart rate variability, ventricular instability and myocardial ischemia in response to emotional stress, and altered platelet function. Effective treatment of depression alleviates depressive symptoms, improves quality of life, and is associated with normalization of many pathophysiologic alterations associated with major depression. Certain newer antidepressant agents appear to offer increased safety in patients with CVD. Future investigations will determine whether antidepressant treatment of the approximately 18%-25% of post-MI patients who fulfill diagnostic criteria for major depression has a significant impact on cardiovascular morbidity and mortality.

Original languageEnglish
Pages (from-to)34-42
Number of pages9
JournalCardiovascular Reviews and Reports
Volume19
Issue number12
StatePublished - Dec 1 1998
Externally publishedYes

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Cardiovascular Diseases
Depression
Myocardial Infarction
Antidepressive Agents
Mortality
Sympathetic Nervous System
Patient Safety
Psychological Stress
Myocardial Ischemia
Blood Platelets
Heart Rate
Quality of Life
Morbidity
Therapeutics
Research

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Depression and cardiovascular disease : Increasing evidence of a connection. / Musselman, Dominique; Nemeroff, Charles.

In: Cardiovascular Reviews and Reports, Vol. 19, No. 12, 01.12.1998, p. 34-42.

Research output: Contribution to journalArticle

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