The Relationship between Psychiatric Illness and the Circadian Pattern of Heart Rate

Stampfer, Hans G.

doi:10.3109/00048679809062728

Cited by 44 publications

(39 citation statements)

References 16 publications

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“…Although the mechanisms of this risk are unclear, depression is associated with other risk factors for cardiac events including elevated heart rate (HR) and low heart rate variability (HRV) (Carney et al, 2005b; Kemp et al, 2010), dysfunctional sleep (Buysse et al, 1998; Ford et al, 1989), and blunted circadian HR rhythm (Stampfer, 1998; Taillard et al, 1990). Following an acute myocardial infarction (MI), for example, compared to non-depressed patients those with depression have higher nighttime HRs (Carney et al, 2008), lower heart rate variability (Carney et al, 2001), and a greater likelihood of having little or no decrease in nighttime HR relative to daytime levels (nocturnal dip) (Carney et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Nighttime heart rate predicts response to depression treatment in patients with coronary heart disease

Carney

Freedland

Steinmeyer

et al. 2016

Journal of Affective Disorders

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Background Previous studies suggest that patients with coronary heart disease (CHD) who do not respond to treatment for depression are at higher risk of mortality than are treatment responders. The purpose of this study was to determine whether elevated nighttime heart rate (HR) and low heart rate variability (HRV), both of which have been associated with depression and with cardiac events in patients with CHD, predict poor response to depression treatment in patients with CHD. Methods Patients with stable CHD and a current major depressive episode completed 24 hour ambulatory ECG monitoring and were then treated for up to 16 weeks with cognitive behavior therapy (CBT), either alone or in combination with an antidepressant. Pre-treatment HR and HRV were calculated for 124 patients who had continuous ECG from early evening to mid-morning. Results Following treatment, 64 of the 124 patients (52%) met study criteria for remission (Hamilton Rating Scale for Depression score < 7). Prior to treatment, non-remitters had higher nighttime HR (p=0.03) and lower nighttime HRV (p=0.01) than did the remitters, even after adjusting for potential confounds. Limitations Polysomnography would have provided information about objective sleep characteristics and sleep disorders. More CBT sessions and higher doses of antidepressants may have resulted in more participants in remission. Conclusions High nighttime HR and low nighttime HRV predict a poor response to treatment of major depression in patients with stable CHD. These findings may help explain why patients with CHD who do not respond to treatment are at higher risk for mortality.

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Section: Introductionmentioning

confidence: 99%

Nighttime heart rate predicts response to depression treatment in patients with coronary heart disease

Carney

Freedland

Steinmeyer

et al. 2016

Journal of Affective Disorders

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“…For example, impaired sleep and daytime fatigue are included in the diagnostic criteria for depressive disorders (American Psychiatric Association, APA, 2000) where diurnal variations in symptoms (e.g., mood and psychomotor activity) have frequently been reported. These fluctuations are reflected in physiological measures such that, compared to a control population, depressive patients show alterations in circadian rhythms of melatonin and (Pacchierotti et al, 2001) cortisol levels (Deuschle et al, 1997); body temperature (Daimon et al, 1992); and heart rate (Stampfer, 1998). Moreover, some interventions that change the timing of the biological clock in the brain (e.g., sleep deprivation, light therapy) have efficacy as treatments for these conditions (Wehr et al, 1979).…”

Section: Introductionmentioning

confidence: 99%

Altered circadian profiles in attention-deficit/hyperactivity disorder: An integrative review and theoretical framework for future studies

Imeraj

Sonuga‐Barke

Antrop

et al. 2012

Neuroscience & Biobehavioral Reviews

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and (iv) rhythmicity in neuroendocrine and neurophysiological responsiveness. On this basis, we propose a neurobiological framework to guide future study, which sees circadian effects in ADHD, along with other aspects of ADHD arousal-related deficits (e.g., cognitive energetic deficits), as being the result of dysregulated locus coeruleus function. Based on this perspective specific recommendations for future research are presented.

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“…(29) There is evidence that not only do depressed but otherwise medically well psychiatric patients have higher 24-hour HR than nondepressed comparison groups, but the difference in HR between depressed and nondepressed patients is more pronounced at night than during the day. (30-32) Sleep disturbance is a common symptom of depression(33, 34), and it may help to explain the higher nighttime HR in depressed patients. (30) Polysomnographic studies have found differences in sleep architecture, as well as more frequent arousals and poorer sleep efficiency, in depressed psychiatric patients compared to controls.…”

Section: Introductionmentioning

confidence: 99%

Nighttime Heart Rate and Survival in Depressed Patients Post Acute Myocardial Infarction

Carney

Steinmeyer

Freedland

et al. 2008

Psychosomatic Medicine

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Background Depression is a risk factor for mortality following acute myocardial infarction (AMI). It is also associated with sleep disturbances, and with elevated heart rate (HR), which may be more pronounced at night. Resting and 24 hour HR have been found to predict mortality in patient and community samples. Objective The purpose of this study was to determine: 1) whether depressed patients with a recent AMI have higher nighttime HR than nondepressed patients, and 2) whether elevated nighttime HR is associated with decreased survival following AMI. Methods Ambulatory ECG data were obtained from 333 depressed and 383 nondepressed patients with a recent AMI. They were followed for up to 30 (median = 24) months. Results Depressed patients had higher nighttime (70.7 ∀ .7 versus 67.7 ∀ .6 bpm; p=.001), and daytime (76.4 ∀.7 versus 74.2 ∀ .6 bpm; p=.02) HR than nondepressed patients, even after adjusting for potential confounds. Depression (H.R. = 2.19; p=.02) and nighttime (H.R. = 1.03; p=.004), but not daytime HR, predicted survival after adjusting for other major predictors and for each other. Conclusions Mean day and nighttime HRs are higher in depressed than in nondepressed patients following an AMI, and both depression and nighttime HR are independent predictors of mortality in these patients. Although depressed patients have a higher nighttime HR than nondepressed patients, elevated nighttime HR predicts mortality independent of depression status.

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The Relationship between Psychiatric Illness and the Circadian Pattern of Heart Rate

Cited by 44 publications

References 16 publications

Nighttime heart rate predicts response to depression treatment in patients with coronary heart disease

Nighttime heart rate predicts response to depression treatment in patients with coronary heart disease

Altered circadian profiles in attention-deficit/hyperactivity disorder: An integrative review and theoretical framework for future studies

Nighttime Heart Rate and Survival in Depressed Patients Post Acute Myocardial Infarction

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