Mental stress, atheroma, myocardial ischaemia and injury: the link is inflammation

Ong, Hean Teik; Chen, Jinghong

doi:10.1136/gpsych-2023-101282

Cited by 2 publications

(1 citation statement)

References 72 publications

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“…Additional data suggest that inflammation can link mental stress to CVD. 6 Previous studies have indicated that an inflammation process fuelled by irregularities in the immune system could potentially explain the connection between CAD and depression. This is evident in the heightened concentrations of interleukin-6, C reactive protein (CRP), fibrinogen and triglycerides.…”

Section: Introductionmentioning

confidence: 99%

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Cao,

Baranova,

Zhao

et al. 2024

BMJ Ment Health

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BackgroundMental disorders have a high comorbidity with cardiovascular disease (CVD), but the causality between them has not been fully appreciated.ObjectiveThis study aimed to systematically explore the bidirectional causality between the two broad categories of diseases.MethodsWe conducted Mendelian randomisation (MR) and multivariable MR (MVMR) analyses to evaluate potential causal links between 10 mental disorders, the use of antidepressants and 7 CVDs.FindingsWe discovered that major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD) and insomnia exhibit connections with elevated risks of two or more CVDs. Moreover, the use of antidepressants is linked to heightened risks of each CVD. Each distinct CVD is correlated with a greater probability of taking antidepressants. Our MVMR analysis demonstrated that the use of antidepressants is correlated with the elevation of respective risks across all cardiovascular conditions. This includes arrhythmias (OR: 1.28), atrial fibrillation (OR: 1.44), coronary artery disease (OR: 1.16), hypertension (OR: 1.16), heart failure (OR: 1.16), stroke (OR: 1.44) and entire CVD group (OR: 1.35). However, MDD itself was not linked to a heightened risk of any CVD.ConclusionsThe findings of our study indicate that MDD, insomnia and ADHD may increase the risk of CVD. Our findings highlight the utilisation of antidepressants as an independent risk factor for CVD, thus explaining the influence of MDD on CVD through the mediating effects of antidepressants.Clinical implicationsWhen treating patients with antidepressants, it is necessary to take into consideration the potential beneficial and detrimental effects of antidepressants.

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Section: Introductionmentioning

confidence: 99%

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Cao,

Baranova,

Zhao

et al. 2024

BMJ Ment Health

View full text Add to dashboard Cite

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Trajectories of depressive symptoms and risk of cardiovascular disease, cancer and mortality: a prospective cohort study

Min,

Cao,

Chen

et al. 2024

Gen Psych

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BackgroundDepressive symptoms are established risk factors for various health outcomes. However, previous studies assessed depressive symptoms at a single time point, neglecting individual variations over time.AimsTo identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease (CVD), cancer and mortality.MethodsThis study included 20 634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006–2016. Group-based trajectory modelling identified depressive symptoms trajectories. Incident CVD, cancer and mortality were followed up until 2021 through linked registries.ResultsSix depressive symptoms trajectories were identified: no symptoms (n=6407), mild-stable (n=11 539), moderate-stable (n=2183), severe-decreasing (n=206), moderate-increasing (n=177) and severe-stable (n=122). During a median follow-up of 5.5 years, 1471 CVD cases, 1275 cancer cases and 503 deaths were documented. Compared with the no symptoms trajectory, the mild-stable, moderate-stable and severe-stable trajectories exhibited higher CVD risk, with hazard ratios (HRs) (95% CIs) of 1.19 (1.06 to 1.34), 1.32 (1.08 to 1.34) and 2.99 (1.85 to 4.84), respectively. Moderate-increasing and severe-stable trajectories were associated with higher mortality risks, with HRs (95% CIs) of 2.27 (1.04 to 4.93) and 3.26 (1.55 to 6.88), respectively. However, the severe-decreasing trajectory was not associated with higher risks of adverse outcomes. We did not find significant associations between any trajectory and cancer.ConclusionsTrajectories related to stable and increasing depressive symptoms, but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up, were associated with higher risks of CVD and mortality. Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.

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Mental stress, atheroma, myocardial ischaemia and injury: the link is inflammation

Cited by 2 publications

References 72 publications

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Bidirectional associations between mental disorders, antidepressants and cardiovascular disease

Trajectories of depressive symptoms and risk of cardiovascular disease, cancer and mortality: a prospective cohort study

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