State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease.
The notion that psychological states can influence physical health is hardly new, and perhaps nowhere has the mind-body connection been better studied than in cardiovascular disease (CVD). Recently, large prospective epidemiologic studies and smaller basic science studies have firmly established a connection between CVD and several psychological conditions, including depression, chronic psychological stress, posttraumatic stress disorder (PTSD), and anxiety. In addition, numerous clinical trials have been conducted to attempt to prevent or lessen the impact of these conditions on cardiovascular health. In this article, we review studies connecting depression, stress/PTSD, and anxiety to CVD, focusing on findings from the last 5 years. For each mental health condition, we first examine the epidemiologic evidence establishing a link with CVD. We then describe studies of potential underlying mechanisms and finally discuss treatment trials and directions for future research.
Department of Medicine, University of California, San Francisco, California, USA; General Internal Medicine, San Francisco VA Medical Center, San Francisco, California, USA; beth.cohen@ucsf.edu.
Beth E
BE
Cohen
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Donald
D
Edmondson
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Ian M
IM
Kronish
D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011580:Psychological Techniques; D011619:Psychotropic Drugs / Q000494:pharmacology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy
D011619:Psychotropic Drugs
PTSD; anxiety disorders; blood pressure; cardiovascular disease; coronary heart disease; depression; hypertension; stress.