TY - JOUR
T1 - Depression, the autonomic nervous system, and coronary heart disease
AU - Carney, Robert M.
AU - Freedland, Kenneth E.
AU - Veith, Richard C.
PY - 2005
Y1 - 2005
N2 - Depression is a risk factor for medical morbidity and mortality in patients with coronary heart disease (CHD). Dysregulation of the autonomic nervous system (ANS) may explain why depressed patients are at increased risk. Studies of medically well, depressed psychiatric patients have found elevated levels of plasma catecholamines and other markers of altered ANS function compared with controls. Studies of depressed patients with CHD have also uncovered evidence of ANS dysfunction, including elevated heart rate, low heart rate variability, exaggerated heart rate responses to physical stressors, high variability in ventricular repolarization, and low baroreceptor sensitivity. All of these indicators of ANS dysfunction have been associated with increased risks of mortality and cardiac morbidity in patients with CHD. Further research is needed to determine whether ANS dysfunction mediates the effects of depression on the course and outcome of CHD, and to develop clinical interventions that improve cardiovascular autonomic regulation while relieving depression in patients with CHD.
AB - Depression is a risk factor for medical morbidity and mortality in patients with coronary heart disease (CHD). Dysregulation of the autonomic nervous system (ANS) may explain why depressed patients are at increased risk. Studies of medically well, depressed psychiatric patients have found elevated levels of plasma catecholamines and other markers of altered ANS function compared with controls. Studies of depressed patients with CHD have also uncovered evidence of ANS dysfunction, including elevated heart rate, low heart rate variability, exaggerated heart rate responses to physical stressors, high variability in ventricular repolarization, and low baroreceptor sensitivity. All of these indicators of ANS dysfunction have been associated with increased risks of mortality and cardiac morbidity in patients with CHD. Further research is needed to determine whether ANS dysfunction mediates the effects of depression on the course and outcome of CHD, and to develop clinical interventions that improve cardiovascular autonomic regulation while relieving depression in patients with CHD.
KW - Autonomic nervous system
KW - Coronary disease
KW - Depression
KW - Depressive disorder
KW - Mortality
KW - Myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=14044261039&partnerID=8YFLogxK
U2 - 10.1097/01.psy.0000162254.61556.d5
DO - 10.1097/01.psy.0000162254.61556.d5
M3 - Review article
C2 - 15953797
AN - SCOPUS:14044261039
VL - 67
SP - S29-S33
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
SN - 0033-3174
IS - SUPPL. 1
ER -