Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease

Robert M. Carney, Kenneth E. Freedland, Richard C. Veith, Philip E. Cryer, Judith A. Skala, Tiffany Lynch, Allan S. Jaffe

Research output: Contribution to journalArticle

124 Scopus citations

Abstract

Background: Although it is now well established that psychiatric depression is associated with adverse outcomes in patients with coronary heart disease (CHD), the mechanism underlying this association is unclear. Elevated heart rate (HR) and plasma norepinephrine (NE), possibly reflecting altered autonomic nervous system activity, have been documented in medically well depressed psychiatric patients, and this pattern is associated with increased risk for cardiac events in patients with CHD. The purpose of this study was to determine whether autonomic nervous system activity is altered in depressed CHD patients. Methods: HR, plasma NE, and blood pressure (BP) were measured in 50 depressed and 39 medically comparable nondepressed CHD patients at rest and during orthostatic challenge. Results: Resting HR (p = .005), and the change from resting HR at 2, 5, and 10 min after standing (p = .02, .004, and .02, respectively), were significantly higher in the depressed than in the nondepressed patients. There were no differences between the groups in NE or in BP at rest, or in standing minus resting change scores at any time during orthostatic challenge (p > .05). Conclusions: Depression is associated with altered autonomic activity in patients with CHD, as reflected by elevated resting HR and an exaggerated HR response to orthostatic challenge. Previously reported differences in NE levels between depressed and nondepressed patients were not replicated.

Original languageEnglish (US)
Pages (from-to)458-463
Number of pages6
JournalBiological psychiatry
Volume45
Issue number4
DOIs
StatePublished - Feb 15 1999

Keywords

  • Autonomic nervous system
  • Coronary heart disease
  • Depressive disorder

ASJC Scopus subject areas

  • Biological Psychiatry

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