Heart rate and blood pressure in panic disorder, major depression, and comorbid panic disorder with major depression

Secondary major depression is common in patients with panic disorder (PD) and has been reported to worsen prognosis. Little is known about the effect of comorbid depression on the autonomic symptoms associated with PD. In this study, the heart rate and blood pressure of 44 patients with PD, 20 patients with major depression (MD), and 12 patients with both panic disorder and depression (PDD) were measured during postural challenge. Patients with PDD were found to have higher diastolic and systolic pressures throughout (P < 0.05), and to have a higher resting cardiac load (P < 0.05). This heightened autonomic arousal remained when the effects of age, race, and the frequency of panic attacks were removed. The results suggest that PDD patients may have increased autonomic dysfunction.