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Treatment of depression in patients with coronary heart disease

W Victor R Vieweg1, Demetrios A Julius, Antony Fernandez

  • 1Psychiatry Services, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA. vvieweg@visi.net

The American Journal of Medicine
|July 11, 2006
PubMed

Insights

Depression is a significant risk factor for developing and worsening coronary heart disease. While treating depression improves mood, its impact on heart disease outcomes requires further investigation.

Area of Science:

  • Cardiology
  • Psychiatry
  • Neuroendocrinology

Background:

  • Depression and coronary heart disease (CHD) frequently co-occur.
  • Depression acts as a risk factor for CHD development and progression.
  • This association is mediated by neuroendocrine pathways affecting atherosclerosis.

Purpose of the Study:

  • To review the link between depression and coronary heart disease.
  • To discuss the impact of depression on heart disease pathogenesis.
  • To outline a treatment approach for depression in CHD patients.

Main Methods:

  • Literature review on depression and CHD.
  • Analysis of neuroendocrine mechanisms.
  • Discussion of treatment strategies including education, counseling, and pharmacotherapy.

Main Results:

  • Depression significantly impacts neuroendocrine pathways, influencing CHD progression.
  • Treating depression improves depressive symptoms in CHD patients.
  • Evidence suggests some antidepressants may benefit CHD course and patient compliance.

Conclusions:

  • Depression is a modifiable risk factor for coronary heart disease.
  • A practical, multi-faceted treatment approach for depression in CHD is recommended.
  • Further research is needed to confirm the benefits of antidepressant treatment on CHD morbidity and mortality.

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