Arterial endothelial function is impaired in treated depression

Abstract

Objectives: To determine whether patients with treated depression but no other risk factors for coronary heart disease (CHD) have abnormal arterial endothelial function, an abnormality that is common to other acquired risk factors for CHD. Design: Case-control study. Setting: Secondary care departments of cardiology and psychiatry in a single centre and the surrounding community. Participants: Patients with treated depression and matched healthy controls, aged 18-55 years, without conventional acquired risk factors for CHD. These were recruited from local community mental health clinics, general practices, and patient support groups, and through posters placed in public areas of the hospital. Patients had major depression as defined in the American Psychiatric Association's Diagnostic and statistical manual of mental disorders, fourth edition. Fifteen patients and 12 controls were recruited, and 12 patients and 10 controls completed the study. Outcomes: Brachial artery flow mediated dilatation and baroreflex sensitivity. Results: Arterial endothelial function measured by flow mediated dilatation was impaired in depression (mean (SEM) −0.7% (1.7%)) compared with controls (5.7% (0.9%), p = 0.005 by non-paired t test). Baroreflex sensitivity did not differ significantly between the groups. Conclusion: Arterial endothelial function is impaired in treated depression. This abnormality may contribute to the increased risk of CHD seen in depression.

Evaluation of Baroreceptor Reflex Function in the Chronic Mild Stress Rodent Model of Depression

“…For example, a previous study from our laboratory found that the olfactory bulbectomy rodent model of depression was associated with a generalized attenuation in sympathoexcitatory responses, but no specific change in the gain of the baroreflex (30). Similarly, Broadley et al (34) found no baroreflex sensitivity differences between normal control subjects and patients who met DSM-IV diagnostic criteria for depression. Also, Watkins et al (18) reported that symptoms of anxiety, but not symptoms of depression, were associated with reduced baroreflex sensitivity in a sample of patients following acute myocardial infarction, suggesting that anxiety may be a mediating factor in this group's previously reported cardiac changes associated with depression.…”

Cerebrovascular Damage in Late-Life Depression Is Associated With Structural and Functional Abnormalities of Subcutaneous Small Arteries

“…Thus, endothelial dysfunction occurs in the large arteries of untreated patients 10 and those taking antidepressant therapy. 11 Compared with matched participants without depression there is also a greater prevalence 12 and incidence 13 of increased carotid intima-media thickness and an increase in aortic pulse wave velocity, 14 even after adjustment for traditional risk factors. The studies to date, however, all pertain to large arteries, and, whereas endothelial dysfunction may be indicative of a proatherogenic state, this does not explain the development of microvascular pathology in the brain.…”

Severity of Depression and Anxiety Symptoms is Associated with Increased Arterial Stiffness in Depressive Disorder Patients Undergoing Psychiatric Treatment

“…Decreased cardiovascular fitness in males who enlisted for military service has been a predictive factor for future depression, thus the association between depression and CVD seems bidirectional 10 . Although the relationship between depression and CVD is unclear in terms of which one triggers another one, previous studies have shown that there is a close relationship between endothelial dysfunction, atherosclerosis, and depression [11][12][13] . Inflammation is another important entity in pathophysiology of cardiovascular disease and depression.…”