Impaired endothelial function in coronary heart disease patients with depressive symptomatology.
OBJECTIVE
The purpose of this study was to assess whether depressive symptomatology was associated with vascular endothelial dysfunction in patients with coronary heart disease (CHD).


BACKGROUND
In patients with CHD, the presence of depression is associated with a two to four times increased risk of mortality, but the disease pathways involved are uncertain. Endothelial dysfunction is an established risk factor for cardiovascular events in patients with CHD.


METHODS
Flow-mediated dilation (FMD) of the brachial artery, a measure of endothelial function, was assessed in 143 patients (99 men, 44 women), ages 40 to 84 years (mean age, 63 +/- 10 years), with documented CHD.


RESULTS
Patients with significant depressive symptomatology, as indicated by a Beck Depression Inventory (BDI) score > or = 10 (n = 47) showed attenuated FMD (p = 0.001) compared with patients that were not depressed (BDI < 10; n = 96). The use of antidepressant medication was associated with improved FMD (p < 0.05).


CONCLUSIONS
The increased risk of cardiovascular events in CHD patients with elevated symptoms of depression may be mediated, in part, by endothelial dysfunction.
Sherwood
Andrew
A
Duke University Medical Center, Durham, North Carolina 27710, USA. sherw002@mc.duke.edu
Hinderliter
Alan L
AL
Watkins
Lana L
LL
Waugh
Robert A
RA
Blumenthal
James A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000503:physiopathology* / Q000523:psychology*; D003863:Depression / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D012039:Regional Blood Flow / Q000502:physiology; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography