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Depression and cardiac disease
C B Nemeroff1, D L Musselman, D L Evans
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Insights
Major depression is common and underdiagnosed in patients with coronary artery disease (CAD). Treating depression in CAD patients improves quality of life and may increase longevity.
Area of Science:
- Cardiology
- Psychiatry
- Psychosomatic Medicine
Background:
- Mood disorders, particularly depression, are increasingly recognized as significant factors in cardiovascular disease (CVD).
- Depression is frequently underdiagnosed and undertreated in patients suffering from coronary artery disease (CAD).
- This lack of diagnosis and treatment is critical, as depression is a major risk factor for both developing CAD and mortality post-myocardial infarction.
Purpose of the Study:
- To summarize the current literature on diagnosing depression in patients with cardiovascular disease (CVD).
- To review the pathophysiological mechanisms linking depression to cardiovascular vulnerability.
- To summarize studies on the treatment of depression in patients with CAD.
Main Methods:
- Literature review focusing on the diagnosis, pathophysiology, and treatment of depression in cardiovascular disease patients.
- Examination of pathophysiological alterations, including heart rate variability and platelet aggregation, in depression.
- Synthesis of studies evaluating depression treatment efficacy in CAD patients.
Main Results:
- Overwhelming evidence indicates major depression and other mood disorders are underdiagnosed and undertreated in CAD patients.
- Depression is identified as a significant risk factor for CAD development and mortality after myocardial infarction.
- Studies suggest depression treatment in CAD patients is effective, enhancing quality of life and potentially longevity.
Conclusions:
- Effective diagnosis and treatment of depression are crucial for managing patients with cardiovascular disease.
- Addressing depression in CAD patients can mitigate risks associated with the disease and improve patient outcomes.
- Further attention to the interplay between mood disorders and cardiovascular health is warranted.
Abstract:
The relationship of mood disorders to cardiovascular disease is receiving considerable attention. The literature on diagnosing depression in patients with cardiovascular disease (CVD), is briefly summarized. There is overwhelming evidence that major depression and other mood disorders, though common, are underdiagnosed and undertreated in patients with coronary artery disease (CAD). This is of paramount importance because depression appears to be a major risk factor in both the development of CAD and in death after myocardial infarction. The pathophysiological alterations in depression that may underlie vulnerability to cardiovascular disease are reviewed with a focus on alterations in heart rate variability and platelet aggregation. The studies on treatment of depression in patients with CAD are also summarized. Treatment of depression in CAD patients appears to be effective, improves quality of life, and might increase longevity.