title: Hormones, heart disease, and health: individualized medicine versus throwing the baby out with the bathwater.
abstract: It is increasingly axiomatic that depression has widespread adverse physiological effects and, conversely, that a variety of physiological systems impact the risk for developing depression. This convergence of depression and altered physiology is particularly dramatic during midlife--a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression. The potentially meaningful and illuminating links between estrogen deficiency, cardiovascular disease (CVD), and depression have largely been obscured, first by assertions, subsequently repudiated, that the perimenopause was not a time of increased risk of depression, and more recently by the denegration of hormone replacement therapy by initial reports of the Women's Health Initiative. Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common, mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of estrogen (E2). This review summarizes data supporting these contentions with the intent of placing depression and estrogen therapy in their proper physiologic context.
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina 27599. USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Rubinow
authors.forename: Susan S
authors.initials: SS
authors.lastname: Girdler
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002318:Cardiovascular Diseases / Q000503:physiopathology* / Q000517:prevention & control; D002979:Climacteric / Q000187:drug effects / Q000502:physiology*; D003866:Depressive Disorder / Q000503:physiopathology* / Q000517:prevention & control; D004195:Disease Models, Animal; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D057285:Precision Medicine; D012307:Risk Factors; D013223:Statistics as Topic
chemical_list: D004967:Estrogens