title: The role of mood disorders in exercise-induced cardiovascular reactivity.
abstract: OBJECTIVE
  Increased cardiovascular (CV) reactivity has been associated with worse CV prognosis. Though mood disorders (MDs) have been associated with increased CV reactivity during behavioral stressors, the extent to which MDs and their interaction with coronary heart disease (CHD) influences exercise-induced CV reactivity has not been evaluated.
  
  
  METHODS
  Five hundred twenty-six patients underwent nuclear exercise stress testing. Cardiovascular parameters were assessed at rest, every 2 minutes during exercise, and at peak exercise. MDs were measured using a structured psychiatric interview, the Primary Care Evaluation of Mental Disorders, and CHD was defined as having a history of myocardial infarction, revascularization, heart failure, and/or cerebrovascular event.
  
  
  RESULTS
  CHD patients exhibited lower peak exercise heart rate (F = 9.40, p = .002) compared with patients without CHD. Submaximal data showed that patients with CHD had a slower rate of increase of heart rate (F = 4.29, p = .04) and diastolic blood pressure (F = 3.27, p = .04). There was an interaction of CHD and MDs, indicating that in patients with CHD, the rate of submaximal increase in systolic blood pressure (F = 3.08, p = .047) and rate-pressure product (F = 5.13, p = .006) was greater in patients with a MD compared with those without a MD. These differences were not observed in patients with no CHD. No other main or interaction effects of MDs and CHD were observed.
  
  
  CONCLUSIONS
  Though MDs alone do not seem to be associated with higher levels of stress CV reactivity, their combination with CHD leads to increased submaximal exercise-induced CV reactivity. Prospective studies are needed to explore the causal relationship between these variables.
authors.affiliation: Montreal Behavioural Medicine Centre, Montreal Heart Institute- a University of Montreal affiliated hospital, Montréal, Québec H1T 1C8, Canada.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Pelletier
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gordon
authors.forename: André
authors.initials: A
authors.lastname: Arsenault
authors.forename: Tavis S
authors.initials: TS
authors.lastname: Campbell
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
mesh_terms: D015992:Body Mass Index; D002637:Chest Pain / Q000175:diagnosis / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000503:physiopathology*; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon