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Researchers-again-pinpoint why stress kills

(February 9, 2004)BETHESDA, MD As Valentine's Day approaches, one prevailing argument for marriage may well be that studies show married people are less depressed than their single counterparts. Behind this string of scientific reasoning for matrimony is a proven fact: the prevalence of depression in patients with coronary artery disease (e.g., myocardial infarction and heart failure) is approximately five times that of the general population.

Background

Major depression is a significant predictor of mortality after myocardial infarction. Its predictive ability on subsequent cardiovascular events, for example, myocardial infarction, arrhythmias, ischemia, or sudden cardiac death, is comparable to that of left ventricular dysfunction, previous myocardial infarction, and smoking. Even more alarming is the finding that depression is a significant risk factor for coronary artery disease in patients without a history of heart disease. In other words, the risk for a heart attack or other cardiac disease for depressed but otherwise healthy patients is similar to the risk for patients with established cardiovascular disease.

Gender does play a role. Psychological depression is a common mood disorder affecting 23% of males and 59% of females. Depression is the leading cause of disability worldwide (quantified by years lived with a disease) and is exceeded only by coronary artery disease as the leading cause of disability in the United States. So, in addition to all the social and medical costs of depression, the disorder is considered a risk factor for coronary artery disease.

Why? Past studies to establish the link between cardiac disease and depression have focused on hypothalamic-pituitary-adrenal axis dysfunction associated with increased sympathetic activation, an imbalance in parasympathetic and sympathetic inputs to the heart (i.e., increased sympathetic tone and/or decreased parasympathetic tone), manifest as reduced heart rate va
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Contact: Donna Krupa
djkrupa1@aol.com
703-527-7357
American Physiological Society
9-Feb-2004


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