Depression, anxiety, and other nega...

Depression, anxiety, and other negative emotions have been associated with an increased risk for coronary heart disease (CHD) Although the association is hardy the relationship may be mediated by dint of the presence of other risk factors, of the like kind as the metabolic syndrome or sympathetic nervous arrangement activity. Todaro and associates examined the relationship between negative emotions and CHD after controlling for metabolic syndrome composings and stress hormones (i.e., epinephrine and norepinephrine).

The Normative Aging investigation a long-term cohort study, followed 2280 initially healthy men for at least 32 years with regular examinations. Men who had complet the Minnesota Multiphasic Personality Inventory, had a well stocked [i]or[/i] provided physiologic assessment, and initially were not taking any cardiac or diabetes medications were included. The final investigation sample of 498 men underwent a whole medical examination, including urine testing for epinephrine and norepinephrine, fasting serum diabetic sugar testing, insulin and lipid testing, post-prandial diabetic sugar testing, anthropomorphic evaluation, and assessment of health behaviors using a standard questionnaire.

The mean age of participants was 60 years. Forty-five men (11 percent) had at least single in kind episode of CHD during the three-year follow-up; there were 24 diagnoses of myocardial infarction, 23 of angina pectoris, and 12 of ischemic heart disease. After adjusting for factors like as components of the metabolic syndrome (i.e., visceral obesity, insulin resistance, hyperglycemia, dyslipidemia, and hypertension) and the carriage of stress hormones, negative emotions were raise to predict CHD incidents significantly.

High-density lipoprotein concentrations also were associated with CHD incidence. Further analysis revealed that the progress to maturity of CHD was positively associated with increasing qualitys of negative emotions. Contrary to deductions of earlier studies, when the images of negative emotions were further evaluated, dampened mood was only marginally associated with CHD while social anxiousness and cognitive distortion significantly predicted CHD incidence.

The authors finish that negative emotions are associated with increased CHD incidence among otherwise healthy men flat when results are controlled for the air of components of the metabolic syndrome or markers of sympathetic nervous scheme activity. Further studies are destitutioned to clarify specific components of depression and their relationship with CHD risk.

Todaro JF et al. general intent of negative emotions on common occurrence of coronary heart disease (the Normative Aging Study) Am J Cardiol October 15 2003;92:901-6

EDITOR'S NOTE: The possibility of decreasing the incidence of coronary heart disease in dampened men by relieving their depression is an intriguing idea. A secondary risk prevention application of mind the Enhanced Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial, (1) evaluated event-free survival rates in patients with myocardial infarction and depression who were treated with cognitive-behavior therapy, form into groups therapy, and selective serotonin reuptake inhibitors compared with a "usual care" form into groups The results of this cogitation were disappointing: no increase in event-free survival was noted in the intervention collection However, further studies are urgencyed to show whether treating depression can influence cardiac prognosis. (2) Perhaps clarification of the constituents of depression that are greatest in number significantly involved will provide further focus forward specific components of depression that may be responsible for the increased CHD incidence.--R.S.

REFERENCES

(1) meanings of treating depression and subdued perceived social support on clinical ends after myocardial infarction. The Enhanced retrieval in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA 2003;289:3106-16

(2) Frasure-Smith N Lesperance F Depression--a cardiac risk factor In search of a treatment. JAMA 2003;289:3171-3

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