Coronary heart disease and depressive disorders, pathogenesis and actual features of the relationship

Abstract

In the conditions of the existing pandemic, that affects both the physical and psychological health of people, it can be predicted with a high degree of probability an outbreak in mental disorders and stress-associated mental illnesses, including depression. The problem of the relationship between depression and cardiac diseases, in particular coronary heart disease (CHD), has been studied by native and foreign scientists for several decades. Various mechanisms have been found and continue to be studied, indicating that the presence of depression can affect more or less on the course of coronary heart disease and even become a predictor of new cardiac events. Dysfunction of the autonomic nervous system with changes in heart rate variability, hyperactivity of the hypothalamic-pituitary-adrenal axis and associated hypercortisolemia, disorders of serotonergic signal transmission pathways, high aggregation response and increased platelet activity, continuous increase of proinflammatory cytokines ((IL17A, IL6, TNFa and IL12p70) in patients’ plasma – such mechanisms probably underlie the correlation between depression and an increased risk of cardiovascular complications and cardiac death. The review includes some features of depression and its influence on various forms of coronary heart disease, particularly in different age and gender groups. In view of the ongoing COVID-19 pandemic, this theme seems to be relevant and requires targeted study. Probably it is necessary to conduct clinical researches, to create registers for a detailed assessment of the mutual influence of depression and coronary heart disease in existing conditions. Perhaps, the results of such work will contribute not only to the early detection and treatment of depression, but also to the development of new ways in primary and secondary prevention of coronary heart disease and its acute forms.