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Severe depression is associated with markedly reduced heart rate variability in patients with stable coronary heart

P K Stein1, R M Carney, K E Freedland

  • 1Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA. steinph@medicine.wustl.edu

Journal of Psychosomatic Research
|July 6, 2000
PubMed

Insights

Moderate to severe depression significantly reduces heart rate variability in cardiac patients. This finding in coronary heart disease patients suggests altered autonomic function and increased mortality risk.

Area of Science:

  • Cardiology
  • Psychiatry
  • Autonomic Nervous System Research

Background:

  • Depression is a common comorbidity in patients with coronary heart disease (CHD).
  • Altered autonomic nervous system (ANS) function, indicated by reduced heart rate variability (HRV), is associated with adverse cardiovascular outcomes.

Purpose of the Study:

  • To investigate the relationship between depression severity and HRV in patients with stable CHD.
  • To determine if depression impacts cardiac autonomic modulation in this patient population.

Main Methods:

  • 40 depressed and 32 non-depressed CHD outpatients underwent 24-hour ambulatory electrocardiographic (ECG) monitoring.
  • Beta-blockers and antidepressant medications were discontinued prior to HRV assessment.
  • Depression severity was classified using Beck Depression Inventory scores (mild vs. moderate-to-severe).

Main Results:

  • No significant demographic or clinical differences between groups, except for depression status.
  • Moderately-to-severely depressed patients exhibited significantly higher heart rates and reduced HRV indices compared to non-depressed patients.
  • Mildly depressed patients showed trends towards higher heart rates and lower HRV, but these did not reach statistical significance.

Conclusions:

  • Moderate to severe depression is associated with significantly reduced heart rate variability in stable CHD patients.
  • This reduction in HRV may indicate impaired cardiac autonomic modulation.
  • The findings suggest a potential mechanism linking depression to increased mortality risk in cardiac patients.
Abstract

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