Abstract
AbstractThere is strong evidence that patients with major depressive disorder (MDD) are at increased risk of developing coronary heart disease. This elevated risk is independent of classical risk factors, such as smoking, obesity, hypercholesterolemia, diabetes and hypertension. The risk of coronary heart disease, put simply, is proportional to the severity of the depression. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial infarction, which materially increases mortality. The mechanism of increased cardiac risk attributable to MDD is at present uncertain, but activation of the sympathetic nervous system, altered baroreflex sensitivity, and/or exaggerated platelet reactivity and endothelial dysfunction are likely to be of prime importance. Copyright © 2008 John Wiley & Sons, Ltd.
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