title: Depression treatment selectively modifies arterial stiffness in older participants.
abstract: BACKGROUND
  Depression is emerging as an independent cardiovascular disease risk factor. We investigated whether treating depression in older participants impacted on arterial stiffness, a known cardiovascular disease risk factor and a clinical marker of arterial aging.
  
  
  METHODS
  Seventy-five participants with pulse wave velocity (PWV), the gold standard measure for arterial stiffness, at baseline and at 12-month follow-up were included. Depressed patients were randomized to escitalopram (10mg/d) or to duloxetine (60mg/d). In patients without depression, no antidepressant therapy was started. The psychologist and the doctor measuring PWV were both unaware of antidepressant treatment.
  
  
  RESULTS
  At study entry, no difference in PWV were observable in the three groups of participants. A significant time × drug interaction term (p < .05) was observed for the impact of antidepressant therapy on PWV by analysis of covariance analysis. After 12 months of therapy, duloxetine treatment resulted in a significant (+21%) and escitalopram treatment in a not significant (6%) PWV increase. These changes in PWV were accompanied by a similar increase in blood pressure and LDL cholesterol in the two treated groups. However, duloxetine resulted in a significant 10% greater heart rate after 12 months that was not observable in participants treated with escitalopram nor in not-depressed older participants. Multiple regression models revealed that a drug-specific effect on PWV persisted after controlling for cardiovascular risk factor levels.
  
  
  CONCLUSIONS
  Duloxetine but not escitalopram significantly increased PWV in older depressed participants after 12 months of treatment. The effect was not fully explained by concomitant changes in traditional cardiovascular risk factors known to significantly impact arterial stiffness.
authors.affiliation: UOC Geriatria, IRCCS INRCA, POR Roma, Italy. angeloelefante@interfree.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Scuteri
authors.forename: Anna
authors.initials: A
authors.lastname: Modestino
authors.forename: Francesca
authors.initials: F
authors.lastname: Fedullo
authors.forename: Antonio Pietro
authors.initials: AP
authors.lastname: Assisi
authors.forename: Walter
authors.initials: W
authors.lastname: Gianni
mesh_terms: D000368:Aged; D000375:Aging; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000187:drug effects; D015283:Citalopram / Q000627:therapeutic use*; D003863:Depression / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000068736:Duloxetine Hydrochloride; D005500:Follow-Up Studies; D006801:Humans; D063177:Pulse Wave Analysis; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D008078:Cholesterol, LDL; D013876:Thiophenes; D015283:Citalopram; D000068736:Duloxetine Hydrochloride