Clinical Research
Endothelial Dysfunction
Impaired Endothelial Function in Coronary Heart Disease Patients With Depressive Symptomatology

https://doi.org/10.1016/j.jacc.2005.05.041Get rights and content
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Objectives

The purpose of this study was to assess whether depressive symptomatology was associated with vascular endothelial dysfunction in patients with coronary heart disease (CHD).

Background

In patients with CHD, the presence of depression is associated with a two to four times increased risk of mortality, but the disease pathways involved are uncertain. Endothelial dysfunction is an established risk factor for cardiovascular events in patients with CHD.

Methods

Flow-mediated dilation (FMD) of the brachial artery, a measure of endothelial function, was assessed in 143 patients (99 men, 44 women), ages 40 to 84 years (mean age, 63 ± 10 years), with documented CHD.

Results

Patients with significant depressive symptomatology, as indicated by a Beck Depression Inventory (BDI) score ≥10 (n = 47) showed attenuated FMD (p = 0.001) compared with patients that were not depressed (BDI <10; n = 96). The use of antidepressant medication was associated with improved FMD (p < 0.05).

Conclusions

The increased risk of cardiovascular events in CHD patients with elevated symptoms of depression may be mediated, in part, by endothelial dysfunction.

Abbreviations and Acronyms

ANCOVA
analysis of covariance
BDI
Beck Depression Inventory
CHD
coronary heart disease
FMD
flow-mediated dilation
GTN
glyceryl trinitrate
GTN-D
glyceryl trinitrate dilation
LDL
low-density lipoprotein
MI
myocardial infarction

Cited by (0)

This research was supported by Grant HL 59672 from the National Institutes of Health, Bethesda, Maryland, and grant M01-RR-30 from the General Clinical Research Center program, National Center for Research Resources, National Institutes of Health.