Effects of Depression, Anxiety, Comorbidity, and Antidepressants on Resting-State Heart Rate and Its Variability: An ELSA-Brasil Cohort Baseline Study
Abstract
OBJECTIVE: Increases in resting-state heart rate and decreases in its variability are associated with substantial morbidity and mortality, yet contradictory findings have been reported for the effects of the mood and anxiety disorders and of antidepressants. The authors investigated heart rate and heart rate variability in a large cohort from Brazil, using propensity score weighting, a relatively novel method, to control for numerous potential confounders. METHOD: A total of 15,105 participants were recruited in the Brazilian Longitudinal Study of Adult Health. Mood and anxiety disorders were ascertained using the Portuguese version of the Clinical Interview Schedule-Revised. Heart rate and its variability were extracted from 10-minute resting-state electrocardiograms. Regressions weighted by propensity scores were carried out to compare participants with and without depressive or anxiety disorders, as well as users and non-users of antidepressants, on heart rate and heart rate variability. RESULTS: Use of antidepressants was associated with increases in heart rate and decreases in its variability. Effects were most pronounced for the tricyclic antidepressants (Cohen's d, 0.72-0.81), followed by serotonin and norepinephrine reuptake inhibitors (Cohen's d, 0.42-0.95) and other antidepressants (Cohen's d, 0.37-0.40), relative to participants not on antidepressants. Only participants with generalized anxiety disorder showed robust, though small, increases in heart rate and decreases in its variability after propensity score weighting. CONCLUSIONS: The findings may, in part, underpin epidemiological findings of increased risk for cardiovascular morbidity and mortality. Many factors that have an adverse impact on cardiac activity were controlled for in this study, highlighting the importance of cardiovascular risk reduction strategies. Further study is needed to examine whether, how, and when such effects contribute to morbidity and mortality.
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Novel analytical methods such as propensity score weighting using generalized boosted modeling may help overcome limitations of traditional analysis, but are yet to be applied to associations between HRV and wellbeing.
“Novel analytical methods such as propensity score weighting using generalized boosted modeling may help to overcome the limitations of traditional analysis (e.g., Kemp et al., 2014), but are yet to be applied to associations between HRV and wellbeing.”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Kemp et al., 2014
Basal heart rate was lower in patients taking SSRIs (mean=65.40 bpm, p=0.003, d=0.161) than in patients taking placebo.
“Interestingly, the basal heart rate was lower in patients taking SSRIs (mean=65.40 bpm, p=0.003, d=0.161) than in patients taking the placebo (Table 1).”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [28]
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“They also decreased heart rate variability (HRV).(28) These negative effects were highest in TCAs (mean=73.”
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“As discussed earlier, lower resting HRV has been associated with depression (Kemp et al., 2010), as well as state and trait anxiety (Kemp et al., 2014; Thayer et al., 1996).”
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“The vast majority of research linking health and HRV has focused on tonic resting-state HRV (Chalmers et al., 2014; Kemp et al., 2014, 2016).”
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“These include anxiety disorders (e.g., Hastings, Nuselovici, et al., 2008; Hastings, Sullivan, et al., 2008; Kemp et al., 2014; Thayer, Friedman, & Borkovec, 1996), attention problems (see Rash & Aguirre-Camacho, 2012), autism (Neuhaus, Bernier, & Beauchaine, 2014; Patriquin, Scarpa, Friedman, & Porges, 2013), bipolar…”
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“Reduced vmHRV relative to controls is reported in major depressive disorder (MDD) (Kemp et al., 2010) and MDD with comorbid generalized anxiety disorder (Kemp et al., 2012), as well as MDD with melancholia (Kemp et al., 2014).”
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“There is epidemiological evidence that the depression–HRV relationship is partly or fully driven by use of antidepressants (Licht et al. 2008, 2010; Kemp et al. 2014; O’Regan et al. 2015).”
BackgroundHeart rate variability in bipolar disorder: A systematic review and meta-analysis
Faurholt‐Jepsen, M., Kessing, L. V., & Munkholm, K. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.12.007 · Cited by 120 · see citing works
“Of these, 17 articles were excluded from review due to 1) not including patients with bipolar disorder (Clamor et al., 2014; Kemp et al., 2014) 2) being a review or comment (Voss et al., 2006) 3) no raw data on mean HRV available (de Pereira et al., 2015), 4) presenting duplicate data (Clarke,…”
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“While it is possible that these persistent reductions in HRV relate to the impact of medications including antidepressants (Kemp et al., 2010; Kemp et al., 2014a; Licht et al., 2010) and medications with anticholinergic effects (often prescribed for hypertension and cardiovascular disease) we…”
BackgroundResultInfluentialA literature review of heart rate variability in depressive and bipolar disorders
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“Subsequently, Kemp et al. (2010) performed a meta-analysis of 18 studies, which examined HRV in 673 patients with MDD and 407 healthy control subjects.”
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“These findings were also complimented by strong and substantial evidence from Bayesian analyses, and provide convergent support for results from past studies, which have indicated that generalised anxiety disorder may be characterised by the most robust reductions in HRV [26, 49].”
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“However, not all studies (Licht et al., 2008) – including our own (Kemp et al., 2014) – have reported reduced HRV in depressed patients highlighting the complexity of this issue.”
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Self-citationDifferences of sympathetic and parasympathetic modulation in major depression
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Heart rate variability as a biomarker of anxious depression response to antidepressant medication
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“In some cases, antidepressant use, rather than depression per se, was found to be associated with reduced HRV (Kemp et al., 2014; Licht et al., 2008; Licht, de Geus, van Dyck, & Penninx, 2010).”
BackgroundResultAssociation of Depressive Symptoms and Heart Rate Variability in Vietnam War–Era Twins
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“Participants on medications including angiotensin-converting enzyme inhibitors, antiarrhythmics, beta blockers, diuretics and sympathetic agonists (Felber et al., 2006), and antidepressants (Kemp et al., 2010, 2014) were also excluded from the present analysis.”
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The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea
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Heart rate variability: Evaluating a potential biomarker of anxiety disorders
Tomasi, J., Zai, C. C. H., Pouget, J. G., Tiwari, A. K., & Kennedy, J. L. (2023) · Psychophysiology · doi:10.1111/psyp.14481 · Cited by 66 · see citing works
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“large cohort study in 2014 reached the contradictory conclusion that only GAD with small effect sizes and not depression or comorbid depression and anxiety disorder were associated with decreased HRV (Kemp et al., 2014).”
BackgroundResultInfluentialBrunoni, A. R., Sampaio-Júnior, B., Moffa, A. H., Borrione, L., Nogueira, B. S., Aparicio, L. V. M., Veronezi, B. P., Moreno, M., Fernandes, R. A., Tavares, D. F., et al. (2015) · Sao Paulo Medical Journal · doi:10.1590/1516-3180.2014.00351712 · Cited by 56 · see citing works
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Hourani, L. L., Davila, M. I., Morgan, J. K., Meleth, S., Ramirez, D., Lewis, G. F., Kizakevich, P. N., Eckhoff, R., Morgan, T., Strange, L. B., et al. (2019) · Physiology & Behavior · doi:10.1016/j.physbeh.2019.112734 · Cited by 55 · see citing works
Held, J., Vîslă, A., Wolfer, C., Messerli‐Bürgy, N., & Flückiger, C. (2021) · BMC Psychology · doi:10.1186/s40359-021-00551-4 · Cited by 53 · see citing works
“Indeed, there is evidence that some anxiety disorders are associated with stronger decreases in HF-HRV than others [1, 32].”
BackgroundResultPhysical Exercise for Late-Life Depression: Effects on Heart Rate Variability
Toni, G., Murri, M. B., Piepoli, M. F., Zanetidou, S., Cabassi, A., Squatrito, S., Bagnoli, L., Piras, A., Mussi, C., Senaldi, R., et al. (2016) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2016.08.005 · Cited by 49 · see citing works
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Self-citationWenzler, S., Hagen, M., Tarvainen, M. P., Hilke, M., Ghirmai, N., Huthmacher, A.-C., Trettin, M., van Dick, R., Reif, A., & Oertel‐Knöchel, V. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.03.040 · Cited by 48 · see citing works
“For example, he found lower RMSSD levels in subjects suffering from melancholia than in a nonmelancholic sample (Kemp et al., 2014b) and reduced RMSSD and HF values in depressed subjects with comorbid generalized anxiety as compared to MDD subjects without comorbid anxiety (Kemp et al., 2012).”
ResultSantos, I. S., Goulart, A. C., Brunoni, A. R., Kemp, A. H., Lotufo, P. A., & Benseñor, I. M. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.04.800 · Cited by 46 · see citing works
Self-citationA systematic review on heart rate variability in Bulimia Nervosa
Peschel, S. K. V., Feeling, N. R., Vögele, C., Kaess, M., Thayer, J. F., & Koenig, J. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.01.012 · Cited by 43 · see citing works
Self-citationResting state vagal tone in attention deficit (hyperactivity) disorder: A meta-analysis
Koenig, J., Rash, J. A., Kemp, A. H., Buchhorn, R., Thayer, J. F., & Kaess, M. (2016) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2016.1174300 · Cited by 42 · see citing works
Self-citationReduced heart rate variability in remitted bipolar disorder and recurrent depression
Bassett, D. L., Bear, N., Nutt, D., Hood, S. D., Bassett, S., & Hans, D. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416652734 · Cited by 41 · see citing works
“Subsequently though, Kemp et al. (2014b) identified that the melancholic sub-type of depressive disorder was indeed associated with reduced HRV, in contrast to non-melancholic depression.”
BackgroundResultKemp, A. H., Koenig, J., Thayer, J. F., Bittencourt, M. S., Pereira, A. C., Santos, I. S., Dantas, E. M., Mill, J. G., Chor, D., Ribeiro, A. L. P., et al. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000359 · Cited by 41 · see citing works
Self-citationKemp, A. H., Brunoni, A. R., Nunes, M. A., Santos, I. S., Goulart, A. C., Ribeiro, A. L. P., Benseãor, I. M., & Lotufo, P. A. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00187 · Cited by 38 · see citing works
“…variability – a predictor of future mortality – is most reduced in MDD patients with GAD (Kemp et al., 2012), demonstrating the adverse effects of distinctive clinical features including a depressive episode, persistent worry, and hypervigilance on cardiac function (see also Kemp et al., 2014).”
BackgroundSelf-citationTomasi, J., Zai, C. C. H., Zai, G. C., Herbert, D., Richter, M. A., Mohiuddin, A. G., Tiwari, A. K., & Kennedy, J. L. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.137 · Cited by 37 · see citing works
Impact of antidepressant use on the autonomic nervous system: A meta-analysis and systematic review
Fiani, D., Campbell, H. M., Solmi, M., Fiedorowicz, J. G., & Calarge, C. A. (2023) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2023.03.013 · Cited by 36 · see citing works
Kemp, A. H., Fráguas, R., Brunoni, A. R., Bittencourt, M. S., Nunes, M. A., Dantas, E. M., Andreão, R. V., Mill, J. G., Ribeiro, A. L. P., Koenig, J., et al. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000336 · Cited by 36 · see citing works
“We recently observed that the SSRIs are associated with a small decrease in HR and HRV (15).”
InfluentialSelf-citationJarczok, M. N., Guendel, H. O., McGrath, J. J., & Balint, E. M. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.86822 · Cited by 35 · see citing works
“Latest research demonstrates associations with common mental disorders like depression [29].”
BackgroundCarnevali, L., Vacondio, F., Rossi, S., Callegari, S., Macchi, E., Spadoni, G., Bedini, A., Rivara, S., Mor, M., & Sgoifo, A. (2015) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.07.015 · Cited by 34 · see citing works
Tatschl, J. M., Hochfellner, S., & Schwerdtfeger, A. R. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00738 · Cited by 37 · see citing works
Heart Rate Variability in Individual Psychotherapy
Blanck, P., Stoffel, M., Bents, H., Ditzen, B., & Mander, J. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000994 · Cited by 34 · see citing works
“…Nerv Ment Dis 2019;207: 451–458) H eart rate variability (HRV) refers to the amount of variation in thetemporal distance between successive heartbeats and has been shown to be related with mental disorders and therapeutic outcome (Angelovski et al., 2016; Chalmers et al., 2014; Kemp et al., 2014).”
BackgroundChang, W. H., Lee, I. H., Chi, M. H., Lin, S., Chen, K. C., Chen, P. S., Chiu, N.-T., Yao, W. J., & Yang, Y. K. (2018) · Scientific Reports · doi:10.1038/s41598-018-20923-y · Cited by 33 · see citing works
Heart Rate Variability for the Prediction of Treatment Response in Major Depressive Disorder
Choi, K. W., & Jeon, H. J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00607 · Cited by 32 · see citing works
“On the contrary, their large-scale longitudinal study showed that SSRI, and serotonin and norepinephrine reuptake inhibitors decreased HRV parameters (82).”
Cardiac autonomic modulation impairments in advanced breast cancer patients
Arab, C., Vanderlei, L. C. M., Paiva, L. D. S., Fulghum, K., Fristachi, C. E., Nazário, A. C. P., Elias, S., Gebrim, L. H., Filho, C. F., Gidron, Y., et al. (2018) · Clinical Research in Cardiology · doi:10.1007/s00392-018-1264-9 · Cited by 32 · see citing works
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“For instance, concurrent comorbidities (neurological disorders, endocrine disorders, ophthalmic conditions, or cardiovascular pathology), medication use, caffeine or alcohol intake, or even sleep hygiene (Ayres et al. 2021; Kemp et al. 2014; Pichora-Fuller et al. 2016).”
BackgroundYoung, H. A., Cousins, A. L., Watkins, H., & Benton, D. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.12.001 · Cited by 31 · see citing works
Diminished autonomic neurocardiac function in patients with generalized anxiety disorder
Kim, K., Lee, S., & Kim, J. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s121533 · Cited by 31 · see citing works
“18,19”
InfluentialAssociations between symptoms of depression and heart rate variability: An exploratory study
Borrione, L., Brunoni, A. R., Sampaio-Júnior, B., Aparicio, L. V. M., Kemp, A. H., Benseñor, I. M., Lotufo, P. A., & Fráguas, R. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.028 · Cited by 31 · see citing works
Self-citationKim, J.-M., Lee, J., Shin, C. M., Lee, D. H., & Park, B. (2015) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2015-000133 · Cited by 30 · see citing works
Kemp, A. H., López, S. R., Passos, V. M. D. A., Bittencourt, M. S., Dantas, E. M., Mill, J. G., Ribeiro, A. L. P., Thayer, J. F., Benseñor, I. M., & Lotufo, P. A. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.04.006 · Cited by 30 · see citing works
“We have described the artefact detection and spectral analytic techniques previously (Dantas et al., 2012; Kemp et al., 2014a).”
BackgroundMethodSelf-citationMulticentric evidence of emotional impairments in hypertensive heart disease
Yoris, A., Legaz, A., Abrevaya, S., Alarco, S., Peláez, J. L., Sanchez, R. A., García, A. M., Ibáñez, A. M., & Sedeño, L. (2020) · Scientific Reports · doi:10.1038/s41598-020-70451-x · Cited by 25 · see citing works
Bupleurum in Treatment of Depression Disorder: A Comprehensive Review
Ran, S., Peng, R., Guo, Q., Cui, J., Chen, G., & Wang, Z. (2024) · Pharmaceuticals · doi:10.3390/ph17040512 · Cited by 26 · see citing works
Brunoni, A. R., Szlejf, C., Suemoto, C. K., Santos, I. S., Goulart, A. C., Viana, M. C., Koyanagi, A., Barreto, S. M., Moreno, A. B., Carvalho, A. F., et al. (2019) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13109 · Cited by 26 · see citing works
Self-citationPsycho-Cardiological Disease: A Bibliometric Review From 2001 to 2021
You, Y., Shou, X., Zhang, X., Fan, S., Chai, R., Xue, W., Hu, Y., & He, Q. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.890329 · Cited by 26 · see citing works
Treatment of affective disorders in cardiac disease
Mavrides, N. A., & Nemeroff, C. B. (2015) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2015.17.2/nmavrides · Cited by 25 · see citing works
Features of autonomic cardiovascular control during cognition in major depressive disorder
Bair, A., Marksteiner, J., Falch, R., Ettinger, U., del Paso, G. A. R., & Duschek, S. (2020) · Psychophysiology · doi:10.1111/psyp.13628 · Cited by 25 · see citing works
Nelson, B. W., Flannery, J., Flournoy, J. C., Duell, N., Prinstein, M. J., & Telzer, E. H. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13471 · Cited by 19 · see citing works
Chang, H., Fang, W., Wan, F.-J., Tzeng, N., Liu, Y., Shyu, J., Chang, T.-C., Huang, S., & Chang, C.-C. (2019) · Psychological Medicine · doi:10.1017/s0033291719001302 · Cited by 23 · see citing works
“Effect sizes are reported as Cohen’s d values; d < 0.2 is considered small, between 0.4 and 0.6, medium, and >0.8 large (Kemp et al., 2014).”
BackgroundResultInfluentialSadeghi, M., Sasangohar, F., McDonald, A. D., & Hegde, S. (2021) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/00187208211034024 · Cited by 23 · see citing works
“, 2015) and antidepressants (Kemp et al., 2014) on resting heart rate in the civilian population.”
BackgroundResultThe Complex Construct of Wellbeing and the Role of Vagal Function
Wilkie, L., Fisher, Z., & Kemp, A. H. (2022) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2022.925664 · Cited by 18 · see citing works
Self-citationChang, C.-C., Tzeng, N., Yeh, C., Kuo, T. B. J., Huang, S., & Chang, H. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1294765 · Cited by 20 · see citing works
“Tricyclic antidepressants (TCAs) are widely known to reduce parasympathetic tone and thus HRV (Kemp, et al. 2010; Kemp et al. 2014).”
BackgroundHeart rate variability predicts outcome of short‐term psychotherapy at the workplace
Balint, E. M., Daniele, V., Langgartner, D., Reber, S. O., Rothermund, E., Gündel, H., von Wietersheim, J., Buckley, T. A., & Jarczok, M. N. (2022) · Psychophysiology · doi:10.1111/psyp.14150 · Cited by 19 · see citing works
Autonomic complexity dynamically indexes affect regulation in everyday life.
Stange, J. P., Li, J., Xu, E. P., Ye, Z., Zapetis, S. L., Phanord, C. S., Wu, J., Sellery, P., Keefe, K., Forbes, E. E., et al. (2023) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000849 · Cited by 18 · see citing works
Magal, N., Rab, S. L., Goldstein, P., Simon, L., Jiryis, T., & Admon, R. (2022) · Chronic Stress · doi:10.1177/24705470221100987 · Cited by 18 · see citing works
Goulart, A. C., Santos, I. S., Bittencourt, M. S., Lotufo, P. A., & Benseñor, I. M. (2015) · Cephalalgia · doi:10.1177/0333102415613611 · Cited by 18 · see citing works
“Finally, we considered all medication about migraine prophylaxis in our multivariable analyses, including drugs such as beta-blockers and antidepressants that could influence some cardiovascular outcomes (41).”
MethodSelf-citationCarnevali, L., Rivara, S., Nalivaiko, E., Thayer, J. F., Vacondio, F., Mor, M., & Sgoifo, A. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.04.013 · Cited by 18 · see citing works
“For example, AEA seems to protect the heart from arrhythmias induced by adrenaline (Ugdyzhekova et al., 2001) or by ischemia-reperfusion procedure (Krylatov et al., 2001).”
Self-citationFantini‐Hauwel, C., Batselé, É., Gois, C., & Noël, X. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00697 · Cited by 18 · see citing works
Komnenov, D., Quaal, H. L., & Rossi, N. F. (2020) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00245.2020 · Cited by 18 · see citing works
Reduced heart rate variability during mania in a repeated naturalistic observational study
Stautland, A., Jakobsen, P., Fasmer, O. B., Osnes, B., Tørresen, J., Nordgreen, T., & Oedegaard, K. J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1250925 · Cited by 19 · see citing works
Wu, X., Zhang, X., Sun, L., Lu, X., & Shen, C. (2023) · Cellular and Molecular Biology · doi:10.14715/cmb/2023.69.7.32 · Cited by 17 · see citing works
Pannu, A. S., & Goyal, R. K. (2024) · Current Drug Safety · doi:10.2174/0115748863301630240417071353 · Cited by 21 · see citing works
Santos, I. S., Bittencourt, M. S., Rocco, P., Pereira, A. C., Barreto, S. M., Brunoni, A. R., Goulart, A. C., Blaha, M. J., Lotufo, P. A., & Bensenor, I. M. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.04.048 · Cited by 17 · see citing works
Self-citationWeissman, D. G., Guyer, A. E., Ferrer, E. E., Robins, R. W., & Hastings, P. D. (2019) · Development and Psychopathology · doi:10.1017/s0954579419000646 · Cited by 18 · see citing works
“…development, including internalizing problems (Bylsma, Salomon, Taylor-Clift, Morris, & Rottenberg, 2014; Hastings, Kahle, & Nuselovici, 2014; Hastings et al., 2008; Kemp et al., 2014; Koenig, Kemp, Beauchaine, Thayer, & Kaess, 2016; Rottenberg, 2007; Rottenberg, Clift, Bolden, & Salomon, 2007).”
BackgroundTonello, L., Silva, I. O., Medeiros, A. R., Donato, A. N. A., Schuch, F. B., Donath, L., & Boullosa, D. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00192 · Cited by 16 · see citing works
“In the case of people with depression, the reduction of HRV has been demonstrated to be linked to the severity of the disease (15, 29, 89), with sympathetic predominance and reduction of parasympathetic activity, resulting in reduced HRV (86, 87).”
BackgroundKoenig, J., Jarczok, M. N., Fischer, J. E., & Thayer, J. F. (2015) · Pain Medicine · doi:10.1111/pme.12825 · Cited by 15 · see citing works
Self-citationGiurgi-Oncu, C., Tudoran, C., ENĂTESCU, V. R., Tudoran, M., Pop, G. N., & Bredicean, C. A. (2020) · Medicina · doi:10.3390/medicina56110590 · Cited by 13 · see citing works
Cardiovascular Variability and Reactivity in Major Depressive Disorder
Duschek, S., Bair, A., Hoffmann, A., Marksteiner, J., Montoro, C. I., & del Paso, G. A. R. (2021) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000277 · Cited by 15 · see citing works
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Diminution of Heart Rate Variability in Bipolar Depression
Hage, B., Britton, B., Daniels, D., Heilman, K., Porges, S., & Halaris, A. (2017) · Frontiers in Public Health · doi:10.3389/fpubh.2017.00312 · Cited by 15 · see citing works
“More recent research has focused on specific medications, and it appears that tricyclic antidepressants (TCAs) are most robust in reducing HRV, followed by serotonin/norepinephrine reuptake inhibitors (46, 47).”
BackgroundEvaluation of low vagally-mediated heart rate variability as an early marker of depression risk
Watanabe, D. K., Jarczok, M. N., Williams, D. P., Koenig, J., & Thayer, J. F. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.051 · Cited by 13 · see citing works
Self-citationSeeley, S. H., Mennin, D. S., Aldao, A., McLaughlin, K. A., Rottenberg, J. A., & Fresco, D. M. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9744-y · Cited by 14 · see citing works
Kao, L.-C., Liu, Y.-W., Tzeng, N., Kuo, T. B. J., Huang, S., Chang, C.-C., & Chang, H. (2016) · Psychiatry Investigation · doi:10.4306/pi.2016.13.4.397 · Cited by 13 · see citing works
Walter, F. A., Gathright, E. C., Redle, J. D., Gunstad, J., & Hughes, J. W. (2019) · Annals of Behavioral Medicine · doi:10.1093/abm/kaz006 · Cited by 13 · see citing works
Heart Rate Variability Predicts Treatment Outcome in Major Depression
(2017) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20170017 · Cited by 13 · see citing works
Behandlung der Depression bei koronarer Herzerkrankung
Agorastos, A., Lederbogen, F., & Otte, C. (2015) · Der Nervenarzt · doi:10.1007/s00115-014-4162-z · Cited by 12 · see citing works
“orthostatische Dysregulation, verlängertes QTc-Interval, AV-Blockierung, reduzierte HRV, erhöhte Inzidenz von plötzlichem Herztod; [12, 42, 51]) als auch auf Inflammations- und metabolische Parameter [61, 62].”
Background
- Authors
- Kemp, A. H., Brunoni, A. R., Santos, I. S., Nunes, M. A., Dantas, E. M., Carvalho de Figueiredo, R., Pereira, A. C., Ribeiro, A. L. P., Mill, J. G., Andreão, R. V., Thayer, J. F., Benseñor, I. M., & Lotufo, P. A.
- Affiliations
- The University of Sydney (AU)
- From University Hospital and the Faculty of Medicine, University of São Paulo, São Paulo, Brazil; the School of Psychology and Discipline of Psychiatry, University of Sydney, Sydney, Australia; the Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; the Collegiate of Biological Sciences, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil; Campus Centro Oeste Dona Lindu, Federal University of São João Del-Rei, Brazil; the Laboratory of Genetics and...
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2014-12-01
- Volume
- 171
- Issue
- 12
- Pages
- 1328-1334
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2119976990
- Cited by
- 189
- References
- 41
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 11 · 2023: 17 · 2022: 13 · 2021: 18 · 2020: 15 · 2019: 18 · 2018: 14 · 2017: 16 · 2016: 27 · 2015: 24 · 2014: 2
- FWCI
- 15.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- resting heart rate, heart rate variability, depression, anxiety disorders, antidepressants, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, generalized anxiety disorder, cardiovascular risk, mood disorders, ELSA-Brasil
- MeSH terms
- Adult, Aged, Antidepressive Agents, Antidepressive Agents, Tricyclic, Anxiety, Anxiety Disorders, Brazil, Cardiovascular Diseases, Depression, Major Depressive Disorder, Female, Heart Rate, Humans, Interview, Psychological, Longitudinal Studies, Male, Middle Aged, Vagus Nerve, Comorbidity, Selective Serotonin Reuptake Inhibitors, Adrenergic Uptake Inhibitors, Mood Disorders, Propensity Score
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