title: Association between major depression and cardiovascular risk: the role of antidepressant medication.
abstract: Major depressive disorder (MDD) is associated with an increased risk for cardiovascular disease (CVD). Apart from biological and life style factors, the use of antidepressants and their potentially adverse effects might contribute to the increased CVD risk. Therefore, we compared cardiovascular risk profiles between relatively young depressed patients without CVD with and without antidepressant medication and healthy participants.
  
  
  
  We investigated 44 depressed patients (with antidepressants N = 20 (13 women), mean age 43.2 years; without antidepressants N = 24 (15 women), mean age 40.0) and 41 healthy participants (matched for sex, age, education). As markers of CVD risk, blood pressure, body mass index (BMI), and plasma levels of fasting glucose, cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and high sensitivity C-reactive protein (h-CRP) were measured.
  
  
  
  We found significant differences between groups for BMI (p < .01), systolic (p = .02) and diastolic blood pressure (p < .01), and glucose (p < .001). Post hoc analyses indicated differences between both patient groups compared to the healthy control group, but not between patients groups. Further controlling for BMI diminished the effect of diagnosis on blood pressure; however, this was not the case for glucose level. There were no between-group differences in cholesterol, LDL, HDL, and h-CRP.
  
  
  
  We found a clearly increased CVD risk in this group of rather young depressed patients. Importantly, there was no significant difference in CVD risk between patients with vs. without antidepressants. This suggests that major depression per se and not antidepressant medication is associated with increased CVD risk.
authors.affiliation: Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany. linn.kuehl@charite.de.
authors.forename: Linn K
authors.initials: LK
authors.lastname: Kuehl
authors.affiliation: Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Muhtz
authors.affiliation: Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Kim
authors.initials: K
authors.lastname: Hinkelmann
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Dettenborn
authors.affiliation: Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.affiliation: Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.affiliation: Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000378:metabolism; D016022:Case-Control Studies; D002784:Cholesterol / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000928:Antidepressive Agents; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: Antidepressants; Blood pressure; Body mass index; Cardiovascular risk; Glucose; Major depression