Virtual Mentor. September 2003, Volume 5, Number 9.
Depression and Heart Disease
Although recent studies have shown a correlation between clinical depression and heart disease in males, proper management with antidepressants can help prevent cardiovascular diseases.
Audiey Kao, MD, PhD
A recent study that followed nearly 1200 Johns Hopkins Medical School male students over 40 years found that those with a history of clinical depression—even a depressive episode more than 10 years prior—were twice as likely to develop coronary artery disease, and the history or incidence of depression raised their risk for heart attack by 20 percent .
Over the past several years, a growing body of research has uncovered a significant association between depression and increased risk for such cardiovascular diseases such as congestive heart failure and stroke. To state it another way, happier, more cheerful people have a lower rate of heart disease. Studies examining the link between depression and heart disease have revealed that :
The hypothesized biological causal link between depression and heart disease is based on the deleterious effect that stress hormones have on the cardiovascular system. During normal stress situations, the body releases more adrenaline and cortisol. While these stress hormones have short-term benefits, long-term exposure to higher than normal levels of cortisol, which are found in patients with depression, have adverse physiological effects. For example, hypercortisolemic depressed patients suffer from resistance to insulin and increased visceral fat, which might partially explain why major depression can be considered a risk factor for cardiovascular disorders .
The preferred antidepressants for people with, or at risk for, heart disease are selective serotonin reuptake inhibitors such as fluoxetine, paroxetine, and sertaline. These medications have fewer cardiac side effects than older tricyclic antidepressants .
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