Impaired Endothelial Function in Coronary Heart Disease Patients with Depressive Symptomatology

Overview

Journal J Am Coll Cardiol

Specialty Cardiology & Vascular Diseases

Date 2005 Aug 16

PMID 16098431

Citations 87

Authors

Andrew Sherwood

Alan L Hinderliter

Lana L Watkins

Robert A Waugh

James A Blumenthal

Affiliations

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Abstract

Objectives: The purpose of this study was to assess whether depressive symptomatology was associated with vascular endothelial dysfunction in patients with coronary heart disease (CHD).

Background: In patients with CHD, the presence of depression is associated with a two to four times increased risk of mortality, but the disease pathways involved are uncertain. Endothelial dysfunction is an established risk factor for cardiovascular events in patients with CHD.

Methods: Flow-mediated dilation (FMD) of the brachial artery, a measure of endothelial function, was assessed in 143 patients (99 men, 44 women), ages 40 to 84 years (mean age, 63 +/- 10 years), with documented CHD.

Results: Patients with significant depressive symptomatology, as indicated by a Beck Depression Inventory (BDI) score > or = 10 (n = 47) showed attenuated FMD (p = 0.001) compared with patients that were not depressed (BDI < 10; n = 96). The use of antidepressant medication was associated with improved FMD (p < 0.05).

Conclusions: The increased risk of cardiovascular events in CHD patients with elevated symptoms of depression may be mediated, in part, by endothelial dysfunction.

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