© 2002 by Heart
EDITORIAL
Depression, stress, and the heart
Department of Epidemiology and Public Health, University College London, London, UK
Correspondence to:
Correspondence to:
Dr PC Strike, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK;
philip@public-health.ucl.ac.uk
Evidence is accumulating that psychosocial factors, in particular depression, contribute to coronary artery disease
Keywords: depression; stress; coronary artery disease
Abbreviations: CAD, coronary artery disease; FMD, flow mediated dilatation; HT, hydroxytryptamine; ICAM-1, intercellular adhesion molecule-1; IL, interleukin; MCP-1, monocyte chemoattractant protein-1; TNF
, tumour necrosis factor
| The first 150 words of the full text of this article appear below. |
There is rapidly growing interest in the interactions between heart and mind. Evidence is accumulating from epidemiological and clinical studies that psychosocial factors contribute to coronary artery disease (CAD). Depression is a common problem with a high degree of associated disability, and has been the focus of much of this work. Depressed individuals are more likely to develop angina, or fatal or non-fatal myocardial infarction, than their non-depressed counterparts. A review of the prospective epidemiological cohort studies into depression and the subsequent development of CAD has shown a possible aetiologic role for depression or hopelessness in eight out of eight studies, even after adjustment for traditional cardiovascular risk factors.1 Overall these studies show a relative risk of approximately twofold of developing CAD for depressed compared with non-depressed groups, with some studies showing a dose–response effect in which greater exposure to depression leads to a higher incidence of coronary events.2 For
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