Heartache and heartbreak-the link between depression and cardiovascular disease

Charles Nemeroff, Pascal Goldschmidt-Clermont

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

The close, bidirectional relationship between depression and cardiovascular disease is well established. Major depression is associated with an increased risk of coronary artery disease and acute cardiovascular sequelae, such as myocardial infarction, congestive heart failure, and isolated systolic hypertension. Morbidity and mortality in patients with cardiovascular disease and depression are significantly higher than in patients with cardiovascular disease who are not depressed. Various pathophysiological mechanisms might underlie the risk of cardiovascular disease in patients with depression: increased inflammation; increased susceptibility to blood clotting (owing to alterations in multiple steps of the clotting cascade, including platelet activation and aggregation); oxidative stress; subclinical hypothyroidism; hyperactivity of the sympatho-adrenomedullary system and the hypothalamic-pituitary-adrenal axis; reductions in numbers of circulating endothelial progenitor cells and associated arterial repair processes; decreased heart rate variability; and the presence of genetic factors. Early identification of patients with depression who are at risk of cardiovascular disease, as well as prevention and appropriate treatment of cardiovascular disease in these patients, is an important and attainable goal. However, adequately powered studies are required to determine the optimal treatment regimen for patients with both depression and cardiovascular disorders.

Original languageEnglish
Pages (from-to)526-539
Number of pages14
JournalNature Reviews Cardiology
Volume9
Issue number9
DOIs
StatePublished - Sep 1 2012

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Cardiovascular Diseases
Pituitary-Adrenal System
Platelet Activation
Blood Coagulation
Hypothyroidism
Platelet Aggregation
Coronary Artery Disease
Oxidative Stress
Heart Failure
Heart Rate
Myocardial Infarction
Hypertension
Inflammation
Morbidity
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Heartache and heartbreak-the link between depression and cardiovascular disease. / Nemeroff, Charles; Goldschmidt-Clermont, Pascal.

In: Nature Reviews Cardiology, Vol. 9, No. 9, 01.09.2012, p. 526-539.

Research output: Contribution to journalArticle

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