Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma

Paz-Filho, Gilberto; Licinio, Júlio; Wong, Ma Li

doi:10.1590/s1516-44462010000200015

Cited by 23 publications

(18 citation statements)

References 163 publications

(139 reference statements)

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“…57, 58 Several authors have suggested that this association of depression and inflammatory markers may be a key biological link in the comorbidity of depression and CVD (see for reviews refs 1,4,7,10,12,13,59). This may be mediated by interactions of inflammatory signaling cascades with several key processes implicated in the pathogenesis and pathophysiology of CVD.…”

Section: Biological Mechanisms Involved In the Cvd-depression Associamentioning

confidence: 99%

The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models

et al. 2012

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A compelling association has been observed between cardiovascular disease (CVD) and depression, suggesting individuals with depression to be at significantly higher risk for CVD and CVD-related mortality. Systemic immune activation, hypothalamic–pituitary–adrenal (HPA) axis hyperactivity, arterial stiffness and endothelial dysfunction have been frequently implicated in this relationship. Although a differential epidemiological association between CVD and depression subtypes is evident, it has not been determined if this indicates subtype specific biological mechanisms. A comprehensive systematic literature search was conducted using PubMed and PsycINFO databases yielding 147 articles for this review. A complex pattern of systemic immune activation, endothelial dysfunction and HPA axis hyperactivity is suggestive of the biological relationship between CVD and depression subtypes. The findings of this review suggest that diagnostic subtypes rather than a unifying model of depression should be considered when investigating the bidirectional biological relationship between CVD and depression. The suggested model of a subtype-specific biological relationship between depression and CVDs has implications for future research and possibly for diagnostic and therapeutic processes.

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Section: Biological Mechanisms Involved In the Cvd-depression Associamentioning

confidence: 99%

The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models

et al. 2012

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“…An association between MS and MDD is well documented although the underlying biological mechanisms for this relationship are less studied. MS-related diseases like CAD and DM have also been associated with MDD [22][23][24]. In this context, oxidative stress may be a common pathophysiological mechanism for the association between MS and MDD.…”

Section: Discussionmentioning

confidence: 99%

Association of paraoxonase-1 activity and major depressive disorder in patients with metabolic syndrome

Arı

Kayrak

Gündüz

et al. 2015

Int J Diabetes Dev Ctries

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Associations between metabolic syndrome (MS) and major depressive disorder (MDD) are well documented although the underlying biological mechanisms for this relationship are less studied. Paraoxonase (PON1) is a highdensity lipoprotein (HDL)-associated enzyme, with demonstrated evidence of strong antioxidant activity. Oxidative stress has been implicated in the pathophysiology of MS and MDD. PON1 activity has been studied to some extent in patients with MS and less in MDD. The aim of this study was to compare serum PON1 activity in patients with MS and MDD, MS without MDD, and normal control groups in the context of the biological mechanism of the association between MS and MDD. In this case-control study, 67 patients with MS and 25 healthy controls from the hospital-university staff were recruited. All patients and healthy controls were assessed by a semi-structured psychiatric interview. Patients with MDD were diagnosed according to the DSM-IV criteria for MDD.Serum PON1 activity was determined with a spectrophotometric method, and the activity was compared between patients with MS and MDD, with MS but without MDD, and control groups. Serum PON1 activity levels were lower in patients with MS and MDD group compared to those in the patients with MS and without MDD group and control group (69.5±24.2, 84.3±34.6, and 97.1±40.8 U/ml, p=0.03, respectively). Post hoc analysis showed that PON1 activity was statically significantly lower in the MS with MDD group than in the control group (p=0.02). Impaired PON1 activity, in the context of enhanced oxidative stress, could be one of the possible underlying biological mechanisms of the MS-MDD association.

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“…Bidirectional associations between depression and cardiovascular diseases have been extensively documented. The mechanisms by which cardiac risk is intensified in people with depression remains to be elucidated; however, preliminary evidence suggests several potential mechanisms . First, neuroendocrine and neurohumoral changes in depressed people may lead to dysfunction of the hypothalamic–pituitary–adrenal axis and activation of the renin–angiotensin–aldosterone system.…”

Section: Discussionmentioning

confidence: 99%

“…Following myocardial infarction, the emergence of clinical depression poses heightened risk of morbidity and mortality . Thus, some previous studies have indicated that depression is bidirectionally associated with a complicated pathophysiological mechanism connected with ischemic CHD . Although depression may be associated with CHD, previous findings of such association have been limited to small population studies, meta‐analysis, and mechanism discussions.…”

mentioning

confidence: 99%

Increased subsequent risk of acute coronary syndrome for patients with depressive disorder: A nationwide population‐based retrospective cohort study

Lin

Chang

et al. 2013

Psychiatry Clin Neurosci

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Aim:The purpose of this study was to explore the possible association between subsequent acute coronary syndrome (ACS) risk and depressive disorder. Methods:We used data from the National Health Insurance system of Taiwan to address the research topic. The exposure cohort contained 10 871 patients with new diagnoses of depressive disorders. Each patient was randomly frequency-matched for sex and age with four participants from the general population who did not have any ACS history before the index date (control group). Cox's proportion hazard regression analyses were conducted to estimate the relation between depressive disorders and subsequent ACS risk.Results: Among patients with depressive disorders, the overall risk for developing subsequent ACS was significantly higher than that of the control group (adjusted hazard ratio: 1.88, 95% confidence interval: 1.63-2.17). Further analysis revealed that the higher risk was observed in patients who were male, were of older age, or whose diagnosis was combined with other comorbidities. Conclusions:The findings from this populationbased retrospective cohort study suggest that depressive disorder is associated with an increased subsequent ACS risk.

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Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma

Cited by 23 publications

References 163 publications

The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models

The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models

Association of paraoxonase-1 activity and major depressive disorder in patients with metabolic syndrome

Increased subsequent risk of acute coronary syndrome for patients with depressive disorder: A nationwide population‐based retrospective cohort study

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