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Depression and heart rate variability in patients with coronary heart disease

Robert M Carney1, Kenneth E Freedland

  • 1Behavioral Medicine Center, 4320 Forest Park Boulevard, Suite 301, St. Louis, MO 63108, USA. carneyr@bmc.wustl.edu

Cleveland Clinic Journal of Medicine
|April 21, 2009
PubMed

Insights

Depression in coronary heart disease (CHD) patients is linked to autonomic nervous system dysfunction. Lower heart rate variability (HRV) in depressed CHD patients may explain their increased cardiac risk and mortality.

Area of Science:

  • Cardiology
  • Psychiatry
  • Autonomic Neuroscience

Background:

  • Depression is prevalent in coronary heart disease (CHD) patients.
  • Depression elevates cardiac morbidity and mortality risk in CHD.
  • Autonomic nervous system dysfunction is implicated in this increased risk.

Purpose of the Study:

  • To review the literature on heart rate variability (HRV) in depressed patients with CHD.
  • To explore the role of HRV in mediating the cardiac risks associated with depression in CHD.

Main Methods:

  • Literature review of studies comparing HRV in depressed versus nondepressed CHD patients.
  • Analysis of findings in both stable CHD and acute coronary event cohorts.

Main Results:

  • Most studies indicate lower HRV in depressed CHD patients compared to nondepressed counterparts.
  • Low HRV is a significant predictor of mortality in CHD patients.
  • Findings are consistent across stable and acute CHD populations.

Conclusions:

  • Depression in CHD is associated with autonomic dysfunction, evidenced by reduced HRV.
  • Reduced HRV may substantially contribute to the elevated cardiac risk and mortality in depressed CHD patients.
  • HRV serves as a potential mechanistic link between depression and adverse cardiac outcomes in CHD.

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