The Association Between Depression and Heart Disease: The Role of Biological Mechanisms

Monteleone, Palmiero

doi:10.1002/9780470972304.ch2

Cited by 1 publication

(1 citation statement)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Althought he available evidence strongly support an association between depression andC HD, then atureo ft he linkbetween these two conditionsstill remains to be clarified.L ifestyle factors,w hich are typical of depressed patients andi ncrease the cardiovascular risk, only partially explain the negative impactofdepression on the outcome of patients witharecent ischemic cardiac event.Biological mechanisms have been also supposeda nd multiple interactions among themh ave been suggested (82).F or example,since cholinergic vagal efferent pathwaysinhibit pro-inflammatoryc ytokiner elease, it is plausible thatt he depression-induced autonomic nervoussystem imbalance, withi ncreased sympathetic and/ord ecreased parasympathetic tone, may lead, on the onehand, to low HRVand other cardiac electrophysiological alterations and, on the other,t oa ctivation of inflammatoryp rocesses, which,i n turn, mayprovokeendothelial dysfunction andactivate the HPAa xis, perpetuating depression-linked hypercortisolemia.…”

Section: Discussionmentioning

confidence: 99%

Depression and coronary heart disease. Clinical characteristics, pathogenetic links and treatment issues

Monteleone¹,

Steardo²,

Maj³

et al. 2012

Die Psychiatrie

View full text Add to dashboard Cite

SummaryIt is widely accepted that depression increases the risk of coronary heart disease (CHD) in healthy people while, in individuals with an existing heart disease, depression is a predictor of recurrent cardiac events and death. It seems that new-onset depression after an acute coronary syndrome (ACS) and not recurrent depression may worsen the cardiovascular outcome, and it has been suggested, although not conclusively proved, that depressive somatic symptoms, could be more cardiotoxic than depressive cognitive symptoms. Both psychosocial (low social support, less adherence to treatment recommendations, physical inactivity) and biological mechanisms (autonomic nervous system dysregulation, platelet and endothelial dysfunctions, inflammation, and neuroendocrine abnormalities) have been hypothesized to explain the link between depression and the increased risk of CHD or adverse cardiovascular prognosis. Randomized controlled clinical trials seem to suggest that depression in CHD patients is poor responsive to both pharmacological and psychotherapeutic treatments. Nevertheless, these trials provide also a robust evidence that CHD depressed patients non responder to antidepressant treatments are at greater risk of adverse cardiac event than patients with successfully treated depression. Therefore, it is advisable that psychiatrists, cardiologists and general practitioners coordinate their efforts in managing depression in CHD patients.

show abstract

Section: Discussionmentioning

confidence: 99%