Depression as a risk factor for cardiac mortality and morbidity: A review of potential mechanisms

Robert M. Carney, Kenneth E. Freedland, Gregory E. Miller, Allan S Jaffe

Research output: Contribution to journalArticle

531 Citations (Scopus)

Abstract

Depression increases the risk of cardiac mortality and morbidity in patients with coronary heart disease (CHD), but the mechanisms that underlie this association remain unclear. This review considers the evidence for several behavioral and physiological mechanisms that might explain how depression increases the risk for incident coronary disease and for subsequent cardiac morbidity and mortality. The candidate mechanisms include: (1) antidepressant cardiotoxicity; (2) association of depression with cardiac risk factor such as cigarette smoking, hypertension, diabetes, and reduced functional capacity; (3) association of depression with greater coronary disease severity; (4) nonadherence to cardiac prevention and treatment regimens; (5) lower heart rate variability (HRV) reflecting altered cardiac autonomic tone; (6) increased platelet aggregation; and (7) inflammatory processes. Despite recent advances in our understanding of these potential mechanisms, further research is needed to determine how depression increases risk for cardiac morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)897-902
Number of pages6
JournalJournal of Psychosomatic Research
Volume53
Issue number4
DOIs
StatePublished - Oct 1 2002

Fingerprint

Depression
Morbidity
Mortality
Coronary Disease
Platelet Aggregation
Antidepressive Agents
Heart Rate
Smoking
Hypertension
Research
Therapeutics

Keywords

  • Coronary heart disease
  • Depression
  • Mechanisms

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Psychology(all)

Cite this

Depression as a risk factor for cardiac mortality and morbidity : A review of potential mechanisms. / Carney, Robert M.; Freedland, Kenneth E.; Miller, Gregory E.; Jaffe, Allan S.

In: Journal of Psychosomatic Research, Vol. 53, No. 4, 01.10.2002, p. 897-902.

Research output: Contribution to journalArticle

Carney, Robert M. ; Freedland, Kenneth E. ; Miller, Gregory E. ; Jaffe, Allan S. / Depression as a risk factor for cardiac mortality and morbidity : A review of potential mechanisms. In: Journal of Psychosomatic Research. 2002 ; Vol. 53, No. 4. pp. 897-902.
@article{c4fd66f12337404a81e4ab6339036687,
title = "Depression as a risk factor for cardiac mortality and morbidity: A review of potential mechanisms",
abstract = "Depression increases the risk of cardiac mortality and morbidity in patients with coronary heart disease (CHD), but the mechanisms that underlie this association remain unclear. This review considers the evidence for several behavioral and physiological mechanisms that might explain how depression increases the risk for incident coronary disease and for subsequent cardiac morbidity and mortality. The candidate mechanisms include: (1) antidepressant cardiotoxicity; (2) association of depression with cardiac risk factor such as cigarette smoking, hypertension, diabetes, and reduced functional capacity; (3) association of depression with greater coronary disease severity; (4) nonadherence to cardiac prevention and treatment regimens; (5) lower heart rate variability (HRV) reflecting altered cardiac autonomic tone; (6) increased platelet aggregation; and (7) inflammatory processes. Despite recent advances in our understanding of these potential mechanisms, further research is needed to determine how depression increases risk for cardiac morbidity and mortality.",
keywords = "Coronary heart disease, Depression, Mechanisms",
author = "Carney, {Robert M.} and Freedland, {Kenneth E.} and Miller, {Gregory E.} and Jaffe, {Allan S}",
year = "2002",
month = "10",
day = "1",
doi = "10.1016/S0022-3999(02)00311-2",
language = "English (US)",
volume = "53",
pages = "897--902",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Depression as a risk factor for cardiac mortality and morbidity

T2 - A review of potential mechanisms

AU - Carney, Robert M.

AU - Freedland, Kenneth E.

AU - Miller, Gregory E.

AU - Jaffe, Allan S

PY - 2002/10/1

Y1 - 2002/10/1

N2 - Depression increases the risk of cardiac mortality and morbidity in patients with coronary heart disease (CHD), but the mechanisms that underlie this association remain unclear. This review considers the evidence for several behavioral and physiological mechanisms that might explain how depression increases the risk for incident coronary disease and for subsequent cardiac morbidity and mortality. The candidate mechanisms include: (1) antidepressant cardiotoxicity; (2) association of depression with cardiac risk factor such as cigarette smoking, hypertension, diabetes, and reduced functional capacity; (3) association of depression with greater coronary disease severity; (4) nonadherence to cardiac prevention and treatment regimens; (5) lower heart rate variability (HRV) reflecting altered cardiac autonomic tone; (6) increased platelet aggregation; and (7) inflammatory processes. Despite recent advances in our understanding of these potential mechanisms, further research is needed to determine how depression increases risk for cardiac morbidity and mortality.

AB - Depression increases the risk of cardiac mortality and morbidity in patients with coronary heart disease (CHD), but the mechanisms that underlie this association remain unclear. This review considers the evidence for several behavioral and physiological mechanisms that might explain how depression increases the risk for incident coronary disease and for subsequent cardiac morbidity and mortality. The candidate mechanisms include: (1) antidepressant cardiotoxicity; (2) association of depression with cardiac risk factor such as cigarette smoking, hypertension, diabetes, and reduced functional capacity; (3) association of depression with greater coronary disease severity; (4) nonadherence to cardiac prevention and treatment regimens; (5) lower heart rate variability (HRV) reflecting altered cardiac autonomic tone; (6) increased platelet aggregation; and (7) inflammatory processes. Despite recent advances in our understanding of these potential mechanisms, further research is needed to determine how depression increases risk for cardiac morbidity and mortality.

KW - Coronary heart disease

KW - Depression

KW - Mechanisms

UR - http://www.scopus.com/inward/record.url?scp=0036806520&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036806520&partnerID=8YFLogxK

U2 - 10.1016/S0022-3999(02)00311-2

DO - 10.1016/S0022-3999(02)00311-2

M3 - Article

C2 - 12377300

AN - SCOPUS:0036806520

VL - 53

SP - 897

EP - 902

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

IS - 4

ER -