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Symptoms of depression linked to early stages of artery disease
February 06, 2007Depressive symptoms—especially physical signs, such as fatigue and loss of appetite—may be associated with thickening arteries, which may reflect an early sign of coronary artery disease, according to a report in the February issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Considerable evidence suggests that depression, anger and other negative emotions are associated with the risk for coronary artery disease, which occurs when the vessels carrying blood to the heart become narrowed and thickened. However, most studies have assessed the risk for heart attack or sudden cardiac death, according to background information in the article. Because these events are later steps in the development of coronary artery disease, it is currently unclear whether depression, anxiety and other negative emotions play a role in early disease processes.
Jesse C. Stewart, Ph.D., then at the University of Pittsburgh School of Medicine and now at Indiana University-Purdue University Indianapolis, and colleagues studied 324 men and women who were an average of 60.6 years old. At the beginning of the study, participants attended 11 visits in a five-month period, including a medical screening; testing for cardiovascular risk factors, including high blood pressure and high cholesterol; questionnaires to assess depression, anxiety, hostility and anger; and ultrasound tests to determine carotid artery intima-media thickness (IMT), a measure of the inner layers of the arteries that is related to early-stage coronary artery disease. Cardiovascular risk factors and IMT were assessed again after three years.
"Regression analyses indicated that higher depressive symptoms at baseline were associated with greater three-year change in carotid intima-media thickness, even after taking into account demographic factors, cardiovascular risk factors, medication use, medical conditions and other correlated negative emotions," the authors write. "Measures of anxiety symptoms, hostility, anger experience and anger expression were each unrelated to intima-media thickness change."
To further understand the role of specific depressive symptoms in IMT, the researchers separated the condition down into two components: a somatic-vegetative score, which includes physical indicators such as fatigue and appetite disturbance, and a cognitive-affective score, which includes sadness, pessimism and other emotions associated with depression. Analysis of each component revealed that the somatic-vegetative score, but not the cognitive-affective score, was linked to IMT thickness.
"Taken together, our results indicate that depression, but perhaps not anxiety and hostility/anger, may be involved in the initiation and/or progression of atherosclerosis," or hardening of the arteries, the authors write. "More specifically, our findings suggest that the somatic-vegetative features of depression that are not shared with other negative emotions may play an important role in the earlier stages of coronary artery disease development."
Few previous studies have looked at several negative emotions at once, but this approach will be critical in understanding the links between these psychological variables and physical disease, they conclude. "Identifying these components, in turn, may provide insights into the mechanisms underlying the negative emotion-coronary artery disease relationships and may facilitate the development of focused interventions designed to reduce the coronary artery disease risk of individuals prone to experience negative emotions."
JAMA and Archives Journals
"Regression analyses indicated that higher depressive symptoms at baseline were associated with greater three-year change in carotid intima-media thickness, even after taking into account demographic factors, cardiovascular risk factors, medication use, medical conditions and other correlated negative emotions," the authors write. "Measures of anxiety symptoms, hostility, anger experience and anger expression were each unrelated to intima-media thickness change."
To further understand the role of specific depressive symptoms in IMT, the researchers separated the condition down into two components: a somatic-vegetative score, which includes physical indicators such as fatigue and appetite disturbance, and a cognitive-affective score, which includes sadness, pessimism and other emotions associated with depression. Analysis of each component revealed that the somatic-vegetative score, but not the cognitive-affective score, was linked to IMT thickness.
"Taken together, our results indicate that depression, but perhaps not anxiety and hostility/anger, may be involved in the initiation and/or progression of atherosclerosis," or hardening of the arteries, the authors write. "More specifically, our findings suggest that the somatic-vegetative features of depression that are not shared with other negative emotions may play an important role in the earlier stages of coronary artery disease development."
Few previous studies have looked at several negative emotions at once, but this approach will be critical in understanding the links between these psychological variables and physical disease, they conclude. "Identifying these components, in turn, may provide insights into the mechanisms underlying the negative emotion-coronary artery disease relationships and may facilitate the development of focused interventions designed to reduce the coronary artery disease risk of individuals prone to experience negative emotions."
JAMA and Archives Journals
Artery Disease Current Events and Artery Disease News RSSMultiple health concerns surface as winter, vitamin D deficiences arrive
A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."
Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
New study links vitamin D deficiency to cardiovascular disease and death
While mothers have known that feeding their kids milk builds strong bones, a new study by researchers at the Heart Institute at Intermountain Medical Center in Salt Lake City suggests that Vitamin D contributes to a strong and healthy heart as well - and that inadequate levels of the vitamin may significantly increase a person's risk of stroke, heart disease, and death, even among people who've never had heart disease.
Early end to key study on benefits of niacin, a B vitamin, in keeping arteries open was premature
Heart experts at Johns Hopkins are calling premature the early halt of a study by researchers at Walter Reed Army Medical Center and Washington Hospital Center on the benefits of combining extended-release niacin, a B vitamin, with cholesterol-lowering statin medications to prevent blood vessel narrowing.
Learning the risks for stroke - and taking action
With this theme in mind, the European Society of Cardiology (ESC) emphasises that most of the risks for stroke are also the major risks for coronary heart disease - and thus the object of the ESC's far-reaching prevention programme.
Obesity may hinder optimal control of blood pressure and cholesterol
Obese patients taking medications to lower their blood pressure and cholesterol levels are less likely to reach recommended targets for these cardiovascular disease risk factors than their normal weight counterparts, according to new research presented at the 2009 Canadian Cardiovascular Congress hosted by the Canadian Cardiovascular Society and the Heart and Stroke Foundation of Canada.
South Asian Canadians failing to get exercise message
Exercise is a wonderful way of boosting heart health, but it's proving to be a tough sell in Ontario South Asian communities, Dr. Milan Gupta told the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Angina in the legs? Time to alert patients and physicians
Edmonton researchers recommend that people over age 40 be screened for peripheral artery disease (PAD), which puts people at high risk for serious medical complications including heart disease, stroke, and possible lower limb amputation.
Calcium scans may be effective screening tool for heart disease
A simple, non-invasive test appears to be an effective screening tool for identifying patients with silent heart disease who are at risk for a heart attack or sudden death.
New type of sirolimus-eluting stent demonstrates superior results
A new type of sirolimus-eluting stent (SES) successfully showed significantly greater neointimal suppression than the paclitaxel-eluting stent (PES) with greater vessel wall integrity surrounding the stent, confirming the finding of superiority of the SES over the PES stent for the trial's primary endpoint of in-stent late loss.
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