Depression and cardiovascular disease: pathogenetic factors of the stress concept

Abstract

To date cardiovascular disorders still represent the most frequent cause of death in our western hemisphere. A number of prospective studies have now been able to show that patients with no prior history of heart disease run a higher risk of developing cardiovascular problems, if they either suffered a number of depressive symptoms or showed a depressive syndrome. Similarly, in patients who have suffered a myocardial infarction the presence of a depressive syndrome is frequently associated with poor clinical prognosis and outcome. Within this context the knowledge of the pathophysiological relationship between affective and cardiovascular disorders constitutes an essential element for instituting effective preventive measures for protecting depressed patients against the risk of suffering cardiovascular problems. The activation of stress-responsive systems during depressive episodes may contribute to metabolic risk factors and dysbalance of the autonomic heart regulation. The present overview provides a summary of current knowledge and findings within this area of research.