Depression and cardiovascular disease: Mechanisms of interaction

被引:359
作者
Joynt, KE [1 ]
Whellan, DJ [1 ]
O'Connor, CM [1 ]
机构
[1] Duke Univ, Med Ctr, Dept Med, Div Cardiol, Durham, NC USA
关键词
depression; cardiovascular disease; autonomic nervous system; heart rate variability; inflammation; platelets;
D O I
10.1016/S0006-3223(03)00568-7
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
This article explores the relationship between depression and cardiovascular disease from a mechanistic standpoint. Depression and cardiovascular disease are two of the most prevalent health problems in the United States and are the two leading causes of disability both in the United States and worldwide. Although depression is a known risk factor for the development of cardiovascular disease, as well as an independent predictor of poor prognosis following a cardiac event, the mechanistic relationship between the two remains unclear. Depression is associated with changes in an individual's health status that may influence the development and course of cardiovascular disease, including noncompliance with medical recommendations, as well as the presence of cardiovascular risk factors such as smoking and hypertension. In addition, depression is associated with physiologic changes, including nervous system activation, cardiac rhythm disturbances, systemic and localized inflammation, and hypercoagulability, that negatively influence the cardiovascular system. Further, stress may be an underlying trigger that leads to the development of both depression and cardiovascular disease. This article reviews seven potential mechanisms for the relationship between depression and cardiovascular disease and presents the available evidence surrounding each mechanism. Finally, future directions for research are discussed. (C) 2003 Society of Biological Psychiatry.
引用
收藏
页码:248 / 261
页数:14
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