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Depression and coronary heart disease

Robert M Carney1, Kenneth E Freedland1

  • 1Washington University School of Medicine, 4320 Forest Park Avenue, Suite 301, St. Louis, Missouri 63108, USA.

Nature Reviews. Cardiology
|November 18, 2016
PubMed

Insights

Depression significantly increases coronary heart disease (CHD) risk. While treating depression hasn't improved cardiac outcomes, improved depression suggests better patient prognosis.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Depression is a major risk factor for coronary heart disease (CHD) and adverse cardiovascular outcomes.
  • Hypothesized biobehavioral mechanisms linking depression and CHD explain only a small portion of the risk.
  • Few clinical trials have investigated if depression treatment improves cardiac events in CHD patients.

Purpose of the Study:

  • To review the evidence on the relationship between depression and coronary heart disease (CHD).
  • To assess the impact of depression treatment on cardiac outcomes in patients with established CHD.
  • To identify future research directions for understanding and managing depression in CHD.

Main Methods:

  • Review of existing clinical trials and secondary analyses examining depression treatment in CHD patients.
  • Analysis of hypothesized biological and behavioral mechanisms linking depression to CHD.
  • Synthesis of current evidence to guide future research and clinical practice.

Main Results:

  • Current depression treatments have not demonstrated improved cardiac outcomes in patients with established CHD.
  • Secondary analyses suggest a potential link between improved depression and better patient prognosis.
  • The direct impact of depression treatment on cardiac events remains inconclusive.

Conclusions:

  • More potent depression interventions are needed for patients with CHD.
  • Identifying high-risk depression subtypes may improve targeted treatment efficacy.
  • Further research into biobehavioral mechanisms is crucial for definitive clinical trials.

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