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Depression and Cardiovascular Disease: An Update on How Course of Illness May Influence Risk
Open accessAbstract
Depression constitutes a novel and independent risk factor for cardiovascular disease, which despite extensive support in the literature has been underappreciated. While much of the evidence for depression as a risk factor for cardiovascular disease is based on studies following myocardial infarction, the elevated vascular risk conveyed by depression is not confined to periods following acute coronary syndromes. For that matter, the risk appears across mood disorders with evidence for even greater risk in bipolar disorder. This review summarizes the literature linking depressive disorders to cardiovascular mortality with a focus on how the course of illness of mood disorders may influence this risk. Mood disorders may influence risk over decades of illness in a dose-response to symptom burden, or the persistence of affective symptomatology. This may be mediated through changes in the activity of the autonomic nervous system, the hypothalamic-pituitary-adrenal axis, and inflammatory cytokines. Whether treatment of depression can mitigate this risk is not established although there are suggestions to support this contention, which could be better studied with more effective treatments of depression and larger standardized samples. Directions for future study of mechanisms and treatment are discussed. Regardless of causal mechanisms, persons with depressive disorders and other risk factors for vascular disease represent a neglected, high-risk group for cardiovascular events. In addition to the appropriate treatment for depression, screening and optimized management of traditional risk factors for cardiovascular diseases is necessary.
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“In mood disorders, for example, vasculopathy has been associated with the long-term course of illness and in proportion to symptom burden or the persistence of mood symptoms [45].”
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“Depression is not only a separate component that increases the risk of cardiovascular illnesses [3], but it also independently increases the risk of mortality in older adults.”
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“Furthermore, helplessness is a predictor of depression in the patients [10], [17], causing complications, recurrence, mortality, and low quality of life [18], [19], [20], [21].”
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Journal of psychosomatic research 2021 year in review
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“Likewise, depressive symptomatology constitutes one of the risk factors for mortality among patients with cardiac and hypertensive conditions [51].”
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“Despite this link, studies failed to demonstrate reduced CVD by treating depression.[6] The major trials for treating depression in the setting of CVS include the following[7]: • SADHART – demonstrated safety of sertraline • ENRICHD – cognitive behavioural therapy improved depression and social isolation • CREATE – ci…”
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“Numerous prospective studies, systemic reviews and meta-analyses have shown link between mood disorder and excess cardiovascular mortality after acute coronary syndrome (ACS).(7) The prevalence of major depression is two times higher in postmenopausal women than in men, older women much more likely than older men to h…”
BackgroundDiscrimination and Cardiovascular Disease in Blacks
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Background
Metadata
- Authors
- Fiedorowicz, J. G.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Fiedorowicz, Jess G.
- ORCID
- Fiedorowicz, Jess G.
- Venue
- Current Psychiatry Reports
- Published
- 2014-08-28
- Volume
- 16
- Issue
- 10
- Pages
- 492-492
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- PMC
- PMC4153989
- OpenAlex
- W2069214992
- Cited by
- 103
- References
- 99
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 13 · 2023: 11 · 2022: 5 · 2021: 14 · 2020: 7 · 2019: 13 · 2018: 9 · 2017: 5 · 2016: 10 · 2015: 9 · 2014: 3
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH083695)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- depression, cardiovascular disease, cardiovascular risk factors, mood disorders, bipolar disorder, clinical course, cardiovascular mortality, myocardial infarction, autonomic nervous system, hypothalamic-pituitary-adrenal axis, inflammatory cytokines, antidepressant treatment, cardiovascular screening
- MeSH terms
- Antidepressive Agents, Cardiovascular Diseases, Humans, Hypothalamo-Hypophyseal System, Inflammation, Pituitary-Adrenal System, Risk Factors, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors, Disease Progression, Mood Disorders
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