The Relationship of Depression to Cardiovascular Disease

Musselman, Dominique L.; Evans, Dwight L.; Nemeroff, Charles B.

doi:10.1001/archpsyc.55.7.580

Cited by 1,393 publications

(863 citation statements)

References 177 publications

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“…Data show that upward of 20% of parturient women suffer from a postpartum mood disorder with 7.1% of postpartum women experiencing a major depressive disorder, up to 19.2% experiencing any depression within 3 months of childbirth, and 8–12% of postpartum women experiencing an anxiety disorder, including generalized anxiety and obsessive‐compulsive disorder (Fairbrother, Janssen, Antony, Tucker, & Young, 2016; Gavin et al., 2005). Despite the many well‐documented negative effects of PPD/A on both maternal (Eaton, Armenian, Gallo, Pratt, & Ford, 1996; Joynt, Whellan, & O'Connor, 2003; Musselman, Evans, & Nemeroff, 1998; Norhayati, Hazlina, Asrenee, & Emilin, 2015; O'Hara & McCabe, 2013; Paul, Downs, Schaefer, Beiler, & Weisman, 2013; Yim, Tanner Stapleton, Guardino, Hahn‐Holbrook, & Dunkel Schetter, 2015) and child (Ashman, Dawson, & Panagiotides, 2008; Dawson et al., 2003; Elgar, McGrath, Waschbusch, Stewart, & Curtis, 2004; Glasheen, Richardson, & Fabio, 2010; Goodman & Brand, 2008; Goodman & Tully, 2007; Lundy & Field Jeffrey, 1996; Marchand & Hock, 1998; Stein et al., 2014; Zahn‐Waxler, Iannotti, Cummings, & Denham, 1990) health, the biological and psychosocial mechanisms through which PPD/A develop remain unclear (Deecher, Andree, Sloan, & Schechter, 2008; Pawluski, Lonstein, & Fleming, 2017; Payne, Palmer, & Joffe, 2009; Zonana & Gorman, 2005). Complicating our understanding of these mood disorders is the fact that PPD/A often occur comorbidly, with PPA frequently preceding PPD (Falah‐Hassani, Shiri, & Dennis, 2016; Reck et al., 2008), and there is growing consensus that anxiety may be a feature of PPD (Navarro et al., 2007).…”

Section: Introductionmentioning

confidence: 99%

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

et al. 2017

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IntroductionThe role of perinatal diet in postpartum maternal mood disorders, including depression and anxiety, remains unclear. We investigated whether perinatal consumption of a Western‐type diet (high in fat and branched‐chain amino acids [BCAA]) and associated gestational weight gain (GWG) cause serotonin dysregulation in the central nervous system (CNS), resulting in postpartum depression and anxiety (PPD/A).MethodsMouse dams were fed one of four diets (high‐fat/high BCAA, low‐fat/high BCAA, high‐fat, and low‐fat) prior to mating and throughout gestation and lactation. Postpartum behavioral assessments were conducted, and plasma and brain tissues assayed. To evaluate potential clinical utility, we conducted preliminary human studies using data from an extant sample of 17 primiparous women with high GWG, comparing across self‐reported postpartum mood symptoms using the Edinburgh Postnatal Depression Scale (EPDS) for percent GWG and plasma amino acid levels.ResultsMouse dams fed the high‐fat/high BCAA diet gained more weight per kcal consumed, and BCAA‐supplemented dams lost weight more slowly postpartum. Dams on BCAA‐supplemented diets exhibited increased PPD/A‐like behavior, decreased dopaminergic function, and decreased plasma tyrosine and histidine levels when assessed on postnatal day (P)8. Preliminary human data showed that GWG accounted for 29% of the variance in EPDS scores. Histidine was also lower in women with higher EPDS scores.ConclusionsThese findings highlight the role of perinatal diet and excess GWG in the development of postpartum mood disorders.

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Section: Introductionmentioning

confidence: 99%

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

et al. 2017

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“…Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (Musselman, Evans, & Nemeroff, 1998). Abnormal HPA-axis function may contribute to CVD risk through a variety of related risk factors, including hypertension, high lipids, insulin resistance, and abdominal obesity, together constituting the metabolic syndrome (Brown, Varghese, & McEwen, 2004).…”

Section: Introductionmentioning

confidence: 99%

Circadian affective, cardiopulmonary, and cortisol variability in depressed and nondepressed individuals at risk for cardiovascular disease

Conrad

Wilhelm

Roth

et al. 2008

Journal of Psychiatric Research

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Depression is a risk factor for cardiovascular disease (CVD) perhaps mediated by hypothalamicpituitary-adrenal (HPA) axis or vagal dysregulation. We investigated circadian mood variation and HPA-axis and autonomic function in older (≥55 years) depressed and nondepressed volunteers at risk for CVD by assessing diurnal positive and negative affect (PA, NA), cortisol, and cardiopulmonary variables in 46 moderately depressed and 19 nondepressed volunteers with elevated CVD risk. Participants sat quietly for 5-min periods (10:00, 12:00, 14:00, 17:00, 19:00, 21:00), and then completed an electronic diary assessing PA and NA. Traditional and respiration-controlled heart rate variability (HRV) variables were computed for these periods as an index of vagal activity. Salivary cortisols were collected at waking, waking+30 min, 12:00, 17:00, and 21:00 hours. Cortisol peaked in the early morning after waking, and gradually declined over the day, but did not differ between groups. PA was lower and NA was higher in the depressed group throughout the day. HRV did not differ between groups. Negative emotions were inversely related to respiratory sinus arrhythmia in nondepressed participants. We conclude that moderately depressed patients do not show abnormal HPA-axis function. Diurnal PA and NA distinguish depressed from nondepressed patients at risk for CVD, while measures of vagal regulation, even when controlled for physical activity and respiratory confounds, do not. Diurnal mood variations of older individuals at risk for CVD differ from those reported for other groups and daily fluctuations in NA are not related to cardiac autonomic control in depressed individuals. KeywordsCardiovascular Disease; Cortisol; Depression; Heart Rate Variability Depression has a major impact on mortality, morbidity, and functional recovery in patients with cardiovascular disease (CVD) (Carney, Freedland, & Sheps, 2004). Several mechanisms have been proposed to explain how depression might increase CVD risk, including Corresponding Author: Frank H. Wilhelm, Ph.D.; Tel.: ++41-61-267 0593; Fax: ++41-61-267 0659; E-mail: frank.wilhelm@unibas.ch; Address: Institute for Psychology, University of Basel, Missionsstrasse 60/62, CH-4055 Basel, Switzerland. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (Musselman, Evans, & Nemeroff, 1998). Abnormal HPA-axis function may contribute to CVD risk through a variety of related risk factors, including hypertension, high lipids, insulin resistance, and abdominal obesity, together constituting the metabolic syndrome (Brown, Varghese, & McEwen, 2004). Several stu...

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“…Moreover, in sample 1 we controlled for the presence of cardiovascular comorbidity as a potential confounder of an association with major depression, as ACE variants have been associated with an increased risk for coronary heart disease and coronary heart disease also predisposes to MDD and vice versa. 15 In sample 2, cardiovascular comorbidities were exclusion criteria for both the case and the control group.…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms in the angiotensin-converting enzyme gene are associated with unipolar depression, ACE activity and hypercortisolism

et al. 2006

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Angiotensin-converting enzyme (ACE) is assumed to influence the activity of the hypothalamic-pituitary-adrenocortical (HPA) system, which shows hyperactivity in the majority of patients with major depression. The ACE gene, known to be associated with cardiovascular disorders, which in turn are accompanied with an increased susceptibility for depression, is therefore a promising candidate gene for affective disorders. We investigated the genetic association between 35 single-nucleotide polymorphisms (SNPs) and an insertion/deletion (I/D)-polymorphism in the ACE gene and the susceptibility for unipolar major depression together with the genetic association with ACE serum activity and functional parameters of the HPA system. Two independent case/control samples with a total of 843 unrelated unipolar depressed patients and 1479 healthy controls were investigated. A case/control sample was screened to detect genetic associations with unipolar major depression. In addition, a replication sample was used to confirm the detected associations and to further investigate functional consequences of the genetic variants associated with depression. In the screening sample, two SNPs within the ACE gene were significantly associated with unipolar major depression. The association with unipolar major depression of one SNP (rs4291) located in the promoter region of the ACE gene was confirmed in our replication sample. The T-allele of this SNP was associated with depression and depressed T-allele carriers showed higher ACE serum activity and HPA-axis hyperactivity. Variants of the ACE gene such as SNP rs4291 are suggested susceptibility factors for unipolar major depression. We could show that SNP rs4291 influences ACE activity and HPA-axis hyperactivity and might therefore represent a common pathophysiologic link for unipolar depression and cardiovascular disease.

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The Relationship of Depression to Cardiovascular Disease

Cited by 1,393 publications

References 177 publications

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

Perinatal western‐type diet and associated gestational weight gain alter postpartum maternal mood

Circadian affective, cardiopulmonary, and cortisol variability in depressed and nondepressed individuals at risk for cardiovascular disease

Polymorphisms in the angiotensin-converting enzyme gene are associated with unipolar depression, ACE activity and hypercortisolism

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