title: Major depressive disorder is associated with attenuated cardiovascular reactivity and impaired recovery among those free of cardiovascular disease.
abstract: OBJECTIVE
  To examine cardiovascular reactivity and recovery to laboratory stress among a naturalistic sample of individuals diagnosed with major depressive disorder (MDD) and healthy control participants. Prospective evidence suggests that MDD confers risk for cardiovascular disease equal to or greater than the risk associated with depressed mood. Enhanced cardiovascular reactivity has been proposed as a mechanism explaining increased risk, but data are inconsistent as to whether depressed individuals exhibit enhanced or attenuated reactivity. Further, few studies have examined appraisal and recovery differences.
  
  
  METHODS
  Participants diagnosed with MDD (N = 25) and healthy control participants (N = 25) engaged in a cardiovascular reactivity protocol including 2 tasks, each followed by a brief recovery period.
  
  
  METHODS
  Blood pressure, heart rate, pre-ejection period, cardiac output and total peripheral resistance were assessed. Appraisals of tasks were assessed prior to each task.
  
  
  RESULTS
  Depressed participants exhibited significantly less systolic blood pressure, heart rate, and cardiac output reactivity during speech, less heart rate reactivity during mirror tracing, and less heart rate recovery after speech and mirror tracing than controls. Depressed participants appraised the tasks as more demanding, threatening, and stressful and reported being less able to cope than controls. Appraisals were related to heart rate reactivity, but appraisals did not mediate the relationship between depression group and reactivity.
  
  
  CONCLUSIONS
  Impaired recovery rather than exaggerated cardiovascular reactivity may partially explain the increased prospective cardiovascular disease risk in depressed individuals.
authors.affiliation: Cardiovascular Psychophysiology Laboratory, University of South Florida, Tampa, FL 33620, USA. ksalomon@cas.usf.edu
authors.forename: Kristen
authors.initials: K
authors.lastname: Salomon
authors.forename: April
authors.initials: A
authors.lastname: Clift
authors.forename: Mardís
authors.initials: M
authors.lastname: Karlsdóttir
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rottenberg
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D001143:Arousal / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012016:Reference Values; D013060:Speech / Q000502:physiology; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult