Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment.
Journal Article (Journal Article;Review)
OBJECTIVE: The present paper reviews the evidence that depression is a risk factor for the development and progression of coronary artery disease (CAD). METHODS: MEDLINE searches and reviews of bibliographies were used to identify relevant articles. Articles were clustered by theme: depression as a risk factor, biobehavioral mechanisms, and treatment outcome studies. RESULTS: Depression confers a relative risk between 1.5 and 2.0 for the onset of CAD in healthy individuals, whereas depression in patients with existing CAD confers a relative risk between 1.5 and 2.5 for cardiac morbidity and mortality. A number of plausible biobehavioral mechanisms linking depression and CAD have been identified, including treatment adherence, lifestyle factors, traditional risk factors, alterations in autonomic nervous system (ANS) and hypothalamic pituitary adrenal (HPA) axis functioning, platelet activation, and inflammation. CONCLUSION: There is substantial evidence for a relationship between depression and adverse clinical outcomes. However, despite the availability of effective therapies for depression, there is a paucity of data to support the efficacy of these interventions to improve clinical outcomes for depressed CAD patients. Randomized clinical trials are needed to further evaluate the value of treating depression in CAD patients to improve survival and reduce morbidity.
Full Text
Duke Authors
- Babyak, Michael Alan
- Blumenthal, James Alan
- Newman, Mark Franklin
- Robins, Clive Justin
- Sherwood, Andrew
- Strauman, Timothy J.
Cited Authors
- Lett, HS; Blumenthal, JA; Babyak, MA; Sherwood, A; Strauman, T; Robins, C; Newman, MF
Published Date
- 2004
Published In
Volume / Issue
- 66 / 3
Start / End Page
- 305 - 315
PubMed ID
- 15184688
Electronic International Standard Serial Number (EISSN)
- 1534-7796
Digital Object Identifier (DOI)
- 10.1097/01.psy.0000126207.43307.c0
Language
- eng
Conference Location
- United States