Depressive Disorder and Cardiovascular Status: Interaction with Inflammation

Abstract

Depressive disorder is a significant contributor to the global burden of disease and is the leading cause of disability. Also, cardiovascular diseases are the principal cause of death in the world. In Singapore, heart diseases are the prime cause of death. In the last decade and a half, the association between depressive disorder and an elevated risk for cardiovascular events has been shown repeatedly. In this study, the effect of systemic immune activation and endothelial dysfunction in depressive disorder was explored in a case-control study of depressed patients and matched healthy controls. Sixty-one patients with depressive disorder and forty-three controls were recruited. Vascular parameters and pro-inflammatory cytokines were assessed and compared with the severity of depressive disorder and the duration of antidepressant use. Blood pressure and IL-6 were significantly higher in the depressed group. SBP was found to be related to the duration of antidepressant use while IL-6 was found to be related to LDL in depressed patients. Also, pulse wave velocity, a measure of arterial stiffness, may be related with severity of depressive disorder and cholesterol in the depressed participants. Furthermore, the Framingham risk score that evaluates the 10-year risk of coronary artery disease is elevated in depressive disorder and may be related to triglyceride levels. The possible mechanisms linking depressive disorder and cardiovascular disease based on our findings are the activation of the inflammatory system and autonomic nervous system dysregulation.