Depression and Cardiovascular Disease: An Update on How Course of Illness May Influence Risk

Fiedorowicz, Jess G.

doi:10.1007/s11920-014-0492-6

Cited by 93 publications

(64 citation statements)

References 93 publications

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“…Our results, in line with some (Fiedorowicz, 2014) but not all studies, suggest that this increase in cardiovascular risk is explained by a longer duration of depression.…”

Section: Discussionsupporting

confidence: 92%

Age at onset of major depression and adulthood cardiovascular risk

Franco

Hoertel

Peyre

et al. 2015

Psychiatry Research

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“…Our results, in line with some (Fiedorowicz, 2014) but not all studies, suggest that this increase in cardiovascular risk is explained by a longer duration of depression.…”

Section: Discussionsupporting

confidence: 92%

Age at onset of major depression and adulthood cardiovascular risk

Franco

Hoertel

Peyre

et al. 2015

Psychiatry Research

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“…Cardiovascular risk factors and comorbid cerebrovascular changes [217] may moderate pharmacological treatment effects or may even have negative effects in the treatment of VaDep [218]. In addition to the appropriate treatment for depression, screening and optimized management of risk factors for cardiovascular and cerebrovascular disease is necessary [219, 220]. Importantly, some data imply that antihypertensive agents, such as beta-blockers, which are widely used by patients with cardiovascular disease, can cause or worsen depression [221].…”

Section: Discussionmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

220

145

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BackgroundVascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”.DiscussionThis diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed.ConclusionThe multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

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“…This large association between depression and heart disease has been replicated in representative samples worldwide [1] and independent of a variety of confounding variables [3]. The development and persistence of depressive symptoms have even been purported to exert adverse vascular effects [4]. …”

Section: Introductionmentioning

confidence: 95%

The development of depressive symptoms during medical internship stress predicts worsening vascular function

Fiedorowicz¹,

Ellingrod²,

Kaplan³

et al. 2015

Journal of Psychosomatic Research

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Objective We sought to prospectively determine whether the onset of internship stress and any subsequent depression alters physiological markers of early vascular disease Methods We explored potential mechanisms linking stress and depression to vascular disease in a prospective cohort of 37 participants exposed to medical internship stress, an established precipitant of depressive symptomatology. Results Change in depressive symptom score from baseline over one year of internship stress was inversely correlated with change in the reactive hyperemia index (RHI), a measure of peripheral endothelial function (r=0.41, p=0.01). The change in depressive symptoms in the first six months of internship was similarly related to change in RHI over one year (r=0.38, p=0.02). While the development of depressive symptoms did not significantly impact changes in endothelial progenitor cells (EPCs), EPCs did significantly decrease with the year of internship stress (11.9 to 3.4 cells/ml blood; p=0.01). Conclusion Endothelial function may be a critical link between stress, depression, and cardiovascular disease and a feasible surrogate outcome for prospective studies.

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Depression and Cardiovascular Disease: An Update on How Course of Illness May Influence Risk

Cited by 93 publications

References 93 publications

Age at onset of major depression and adulthood cardiovascular risk

Age at onset of major depression and adulthood cardiovascular risk

Vascular depression consensus report – a critical update

The development of depressive symptoms during medical internship stress predicts worsening vascular function

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