Depressive symptoms and cardiovascular reactivity to laboratory behavioral stress

Abstract

Although a growing literature associates depressive symptoms with cardiovascular disease (CVD), the mechanisms underlying this association have not been clearly determined. The cardiovascular reactivity (CVR) hypothesis suggests that chronically elevated CVR during psychological distress can confer disease risk via vascular alterations. This investigation is a quantitative review of studies that evaluated the association of depressive symptoms with CVR. A total of 60 hypotheses were tested: 21 tests involved systolic blood pressure (SBP), 21 involved diastolic blood pressure (DBP), and 18 involved heart rate (HR). The aggregate effect size for the relation between depressive symptoms and HR reactivity was moderate (d = 0.37); aggregate effect sizes were small for SBP reactivity (d = 0.13) and DBP reactivity (d = 0.17). Effect sizes involving SBP reactivity were homogenous, whereas effect sizes involving DBP and HR reactivity were higher for studies that examined participants with CVD. These findings provide partial support for the associations of depressive symptoms with CVR.

Dysphoria and Mobilization of Mental Effort: Effects on Cardiovascular Reactivity

“…Our studies demonstrate that dysphoric individuals tend to mobilize more resources in terms of SBP reactivity when they are asked to do their best. A tendency to strong cardiovascular reactivity is in turn associated with and considered as a risk factor for the development of hypertension and cardiovascular disease (e.g., Kibler & Ma, 2004;Light, Dolan, Davis, & Sherwood, 1992). One may argue that among other factors, also affective states play an important role in the linkage between depression and coronary heart disease-for instance because of stronger sympathetic activation induced by subjectively higher task demand in a (dispositionally) more negative mood (see Gendolla & Richter, 2005).…”

Blunted cardiovascular reactivity relates to depression, obesity, and self-reported health

“…For example, in a study of 91 healthy participants, those with high amounts of depressive symptoms manifested significantly greater systemic vascular resistance in response to a stressor task than did those with low amounts of depressive symptoms 5 (Matthews et al, 2005). A meta-analysis of 11 relevant studies found small to moderate effect sizes indicative of a positive relationship between depressive symptomatology and cardiovascular reactions to acute psychology stress (Kibler and Ma, 2004). Unfortunately, none of the aggregate effects were statistically significant at conventional levels.…”

“…The mediators and mechanisms underlying this association have yet to be established, but might include factors such as socio-economic position; ill-health and disability; unhealthy behaviours (Wulsin et al, 1999); increased platelet aggregation (Mikuni et al, 1992); and exaggerated cardiovascular reactions to psychological stress exposure (Kibler and Ma, 2004). With regard to this latter possibility, depression has been associated with a variety of physiological adaptations that suggest altered autonomic function.…”

Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks

“…3 In particular, a meta-analysis of 11 studies conducted from 1887 to 2001 suggested that there was a small to moderate positive correlation between cardiovascular reactivity and depressive symptoms; however, these effect sizes did not reach conventional criteria for statistical significance. 4 Other, more recent studies have provided limited support for this hypothesis. For example, Pointer et al reported that state anxiety was positively associated with blood pressure (BP) responses to cold pressor and anger recall in 50 healthy adults.…”