Stress, depression, and coronary artery disease: Modeling comorbidity in female primates

Carol A. Shively, Dominique L. Musselman, Stephanie L. Willard

Research output: Contribution to journalReview articlepeer-review

65 Scopus citations


Depression and coronary heart disease (CHD) are leading contributors to disease burden in women. CHD and depression are comorbid; whether they have common etiology or depression causes CHD is unclear. The underlying pathology of CHD, coronary artery atherosclerosis (CAA), is present decades before CHD, and the temporal relationship between depression and CAA is unclear. The evidence of involvement of depression in early CAA in cynomolgus monkeys, an established model of CAA and depression, is summarized. Like people, monkeys may respond to the stress of low social status with depressive behavior accompanied by perturbations in hypothalamic-pituitary-adrenal (HPA), autonomic nervous system, lipid metabolism, ovarian, and neural serotonergic system function, all of which are associated with exacerbated CAA. The primate data are consistent with the hypothesis that depression may cause CAA, and also with the hypothesis that CAA and depression may be the result of social stress. More study is needed to discriminate between these two possibilities. The primate data paint a compelling picture of depression as a whole-body disease.

Original languageEnglish (US)
Pages (from-to)133-144
Number of pages12
JournalNeuroscience and Biobehavioral Reviews
Issue number2
StatePublished - Feb 2009
Externally publishedYes


  • Cholesterol
  • Coronary heart disease
  • Depression
  • Heart rate
  • Inflammation
  • Neural serotonergic function
  • Ovarian function
  • Platelet reactivity

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Cognitive Neuroscience
  • Neuropsychology and Physiological Psychology


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