Metyrapone Improves Endothelial Dysfunction in Patients With Treated Depression

Broadley, Andrew; Korszun, Ania; Abdelaal, Eltigani; Moskvina, Valentina; Deanfield, John; Jones, Christopher J.; Frenneaux, Michael

doi:10.1016/j.jacc.2005.12.078

Cited by 61 publications

(40 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[31][32][33] Endothelial function is also impaired during and after episodes of depression, 34 -37 even among patients with CAD, 38 perhaps via effects of depression on cortisol release. 39 Depression could indirectly alter control of other atherosclerotic risk factors through its effects on weight, smoking, alcohol use, and exercise, and the present results suggested that addition of these factors might indeed account for a portion of the observed association of depressive symptoms with atherosclerosis.…”

Section: Discussionsupporting

confidence: 52%

Depressive Symptoms and the Risk of Atherosclerotic Progression Among Patients With Coronary Artery Bypass Grafts

et al. 2008

View full text Add to dashboard Cite

Background-Depressive symptoms have been associated with increased risk of coronary artery disease and poor prognosis among patients with existing coronary artery disease, but whether depressive symptoms specifically influence atherosclerotic progression among such patients is uncertain. Methods and Results-The Post-CABG Trial randomized patients with a history of coronary bypass graft surgery to either an aggressive or a moderate lipid-lowering strategy and to either warfarin or placebo. Coronary angiography was conducted at enrollment and after a median follow-up of 4.2 years. Depressive symptoms were assessed at enrollment with the Centers for Epidemiologic Studies Depression scale (CES-D) in 1319 patients with 2496 grafts. In models that adjusted for age, gender, race, treatment assignment, and years since coronary bypass graft surgery, a CES-D score Ն16 was positively associated with risk of substantial graft disease progression (OR 1.50, 95% CI 1.08 to 2.10, Pϭ0.02) and marginally associated with a 0.11-mm (95% CI Ϫ0.22 to 0.01 mm, Pϭ0.07) decrease in minimum lumen diameter, but not with risk of graft occlusion (Pϭ0.30). Additional adjustment for past medical history, blood pressure, and renal function did not materially alter these results. This association was virtually absent among participants randomly assigned to aggressive lipid-lowering therapy. Conclusions-These findings suggest that depressive symptoms are associated with a higher risk of atherosclerotic progression among patients with saphenous vein grafts and that aggressive lipid lowering can minimize this increased risk. Whether depressive symptoms increase progression in other types of coronary atherosclerosis and whether aggressive lipid lowering attenuates such progression will require additional study.

show abstract

Section: Discussionsupporting

confidence: 52%

Depressive Symptoms and the Risk of Atherosclerotic Progression Among Patients With Coronary Artery Bypass Grafts

et al. 2008

View full text Add to dashboard Cite

show abstract

“…ACTH stimulates secretion and growth of zona fasciculate and zona reticularis of adrenal gland and stimulates the secretion of cortisol. Therefore, there is an increase in plasma cortisol level (22). However, the results showed that the level of serum glucose was approximately same in both groups after noise exposure.…”

Section: Control Groupmentioning

confidence: 79%

Noise Exposure Effects on Blood Glucose, Cortisol and Weight Changes in the Male Mice

et al. 2016

View full text Add to dashboard Cite

Background: Noise is one of the most important hazardous factors in industrial environments. Noise has many important negative effects on health; it can cause damage auditory, visual, neurological and psychological and hormonal systems, and physiological and cognitive functions. Objectives: The current study aimed to investigate the effects of noise exposure on changes in glucose and cortisol serum levels in adult male mice. Methods: A total of 24 adult male mice were randomly divided into two experimental and one control groups. One of the experimental groups was exposed to a noise pressure level of 90 dB played by Cool Edit software on a computer in a frequency range 700 -5700 Hz, and the other one was exposed to the same noise and received an injection of streptozotocin (60 mg/kg). The experimental groups were exposed to the noise for 30 days, eight hours per day. Twenty-four hours after the end of the exposure period the fasting cortisol and glucose serum levels were measured in the mice of the three groups. Results:The study results showed a significant difference in the level of glucose in non-diabetic and diabetic groups exposed to the noise, compared to the control subjects (P < 0.002). In addition, there was a significant difference in the level of cortisol in non-diabetic and diabetic groups exposed to the noise, compared to the control groups (P < 0.002). Conclusions:The results showed that exposure to a 90 dB noise can increase cortisol and glucose levels. Hence, in work environments where people are exposed to noise, it is expected that such noises have a negative impact on them and the noise may increase cortisol and blood sugar levels.

show abstract

“…The model predicts that standard depression treatments will probably be ineffective for somatic depressions because of their atypical etiology and underlying neurophysiology. Standard depression treatments must lead to significant improvement in CAD risk factors in order to normalize atherosclerosis- and CAD-associated abnormalities, including increased systemic inflammation, platelet activation (except selective serotonin reuptake inhibitors), endothelial dysfunction, reduced heart rate variability, and baroreceptor sensitivity [117]. If most depressions in ACS patients consist of the somatic type, screening seems problematic since somatic depression has no clearly effective treatment yet.…”

Section: Discussionmentioning

confidence: 99%

Unipolar Depression and the Progression of Coronary Artery Disease: Toward an Integrative Model

Ormel¹,

Jonge

2011

Psychother Psychosom

View full text Add to dashboard Cite

Background: Despite extensive research on the relationship between depression and coronary artery disease (CAD) after an acute coronary syndrome (ACS), causal interpretations are still difficult. This uncertainty has led to much confusion regarding screening and treatment for depression in CAD patients. Method: A critical and conceptual analysis of the pertinent literature, which elaborates the implications of the heterogeneity in symptom pattern, etiology, and course of depression in CAD patients. Results: We propose an integrative dynamic model of the depression-CAD relationship. The model rests on three core hypotheses: (1) Depression in CAD patients consists of mixtures of two types of depression, denoted as ‘cognitive/affective’ and ‘somatic’ depression, each having a somewhat characteristic symptom expression and etiology. (2) Effects of depression on CAD depend on the type and duration of depression. The dynamic aspect of the model indicates that post-ACS depression shifts, when it persists, from a marker of the severity (somatic type) and meaning (cognitive/affective type) of the ACS to a largely indirect causal factor in the progression of CAD. (3) The most plausible pathways mediating the effects of persistent/recurrent depression, irrespective of type, on cardiac prognosis are behavioral and act by making depressed CAD patients more susceptible to other CAD risks. The model offers testable predictions and explanations for a variety of apparently unrelated or inconsistent findings. Conclusion: The proposed model may have potential for integrating findings regarding the depression-CAD relationship, contributing to the clarification of discords on screening and treatment of depression, and guiding future research.

show abstract

Metyrapone Improves Endothelial Dysfunction in Patients With Treated Depression

Abstract: Inhibition of cortisol production by metyrapone ameliorates the endothelial dysfunction seen in depression, suggesting that the mechanism of the endothelial dysfunction may involve cortisol.

Cited by 61 publications

References 37 publications

Depressive Symptoms and the Risk of Atherosclerotic Progression Among Patients With Coronary Artery Bypass Grafts

Depressive Symptoms and the Risk of Atherosclerotic Progression Among Patients With Coronary Artery Bypass Grafts

Noise Exposure Effects on Blood Glucose, Cortisol and Weight Changes in the Male Mice

Unipolar Depression and the Progression of Coronary Artery Disease: Toward an Integrative Model

Contact Info

Product

Resources

About