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Association between depression and macrovascular disease: a mini review
Shuwu Zhao1, Liping Zhu2, Jinfeng Yang1
1Department of Anesthesiology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Frontiers in Psychiatry
|July 17, 2023
Summary
Depression and macrovascular diseases share a bidirectional relationship, with shared physiological mechanisms like hormonal imbalances and inflammation contributing to both conditions. Understanding these links is key for developing integrated prevention and treatment strategies.
Area of Science:
- Cardiovascular Medicine
- Neuroscience
- Psychiatry
Background:
- Depression and macrovascular diseases (coronary artery disease, cerebrovascular disease, peripheral artery disease) are significant global health issues with high mortality and disability.
- Clinical observations show a bidirectional relationship: cardiovascular disease patients have higher depression rates, and depression increases macrovascular disease risk.
Purpose of the Study:
- To review the physiological and pathological mechanisms underlying the comorbidity between depression and macrovascular diseases.
- To explore the intricate connection and interplay between these two prevalent conditions.
Main Methods:
- Review of existing literature on the physiological and pathological mechanisms linking depression and macrovascular diseases.
- Analysis of the impact of hormonal, inflammatory, and nervous system dysfunctions on the comorbidity.
Main Results:
- Atypical hypothalamic-pituitary-adrenal axis activity, with elevated cortisol, disrupts endothelial function and causes vascular narrowing.
- Proinflammatory cytokines (e.g., interleukin-1, C-reactive protein) affect blood-brain barrier permeability, exacerbating depressive symptoms.
- Platelet hyperactivation, endothelial dysfunction, and autonomic nervous system dysfunction are key mechanisms in this comorbidity.
Conclusions:
- These interconnected mechanisms provide a physiological basis for the comorbidity between depression and macrovascular diseases.
- Interdisciplinary collaboration is essential for future research into pathogenesis and for developing tailored prevention and treatment strategies.
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