Depression and cardiovascular disease

Abstract

This review includes publications over the past 12 months that examine the relationship between depression and cardiovascular disease. Epidemiological data now firmly support the negative impact of depression on the development of ischemic heart disease and increased morbidity and mortality in cardiac patients with co-morbid depression. Within this review period, the link between depression and heart disease has been further strengthened. In addition to the adverse effects of depression on the development of ischemic heart disease, there is now evidence of a similar negative impact on women with congestive heart failure. Platelet dysfunction, autonomic dysregulaton, and inflammatory processes have been measured in depressed cardiac patients and offer possible mechanisms for end-organ damage. Depression is underdiagnosed and undertreated in the unstable cardiac patient. There is now convincing data for the safety and efficacy of sertraline in patients with unstable angina and status post-myocardial infarction. Depression remains an independent risk factor for the development of heart disease, specific pathophysiological mechanisms are emerging that may explain causality, and clinicians now have well-controlled multi-center data as a basis for pharmacological treatment.