Skip to main content
Erschienen in: Der Nervenarzt 11/2012

01.11.2012 | Leitthema

Depression: Risikofaktor für kardiovaskuläre Erkrankungen

verfasst von: L.K. Kuehl, B.W.J.H. Penninx, C. Otte

Erschienen in: Der Nervenarzt | Ausgabe 11/2012

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Depression ist ein unabhängiger Risikofaktor für die Entstehung und einen ungünstigen Verlauf einer kardiovaskulären Erkrankung. Dabei spielen depressionsassoziierte Veränderungen biologischer Parameter sowie Verhaltensvariablen eine wichtige Rolle. Diese Faktoren werden als mögliche Mechanismen in diesem Beitrag näher erläutert. Zu den möglichen biologischen Faktoren gehören Veränderungen des autonomen Nervensystems, der Hypothalamus-Hypophysen-Nebennierenrinden-Achse, des Immunsystems sowie des Gerinnungssystems. Zusätzlich steigt durch eine Depression das Risiko für weitere Erkrankungen, wie Diabetes oder Adipositas, die selbst ein erhöhtes kardiovaskuläres Risiko beinhalten. Auf der Verhaltensebene finden sich oft Veränderungen hin zu einem ungesunden Lebensstil, z. B. durch vermehrtes Rauchen und körperliche Inaktivität. Eine Depression erschwert außerdem erforderliche Verhaltensänderungen und eine Medikamentenadhärenz. Bei der antidepressiven Medikation wiederum muss das kardiovaskuläre Risikoprofil verschiedener Substanzen bedacht werden. Alle diese Faktoren spielen eine wichtige Rolle im Zusammenhang zwischen Depression und kardiovaskulären Erkrankungen.
Literatur
1.
Zurück zum Zitat Barth J, Schumacher M, Herrmann-Lingen C (2004) Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med 66:802–813PubMedCrossRef Barth J, Schumacher M, Herrmann-Lingen C (2004) Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med 66:802–813PubMedCrossRef
2.
Zurück zum Zitat Benedict CR, Shelton B, Johnstone DE et al (1996) Prognostic significance of plasma norepinephrine in patients with asymptomatic left ventricular dysfunction. SOLVD Investigators. Circulation 94:690–697PubMedCrossRef Benedict CR, Shelton B, Johnstone DE et al (1996) Prognostic significance of plasma norepinephrine in patients with asymptomatic left ventricular dysfunction. SOLVD Investigators. Circulation 94:690–697PubMedCrossRef
3.
Zurück zum Zitat Black PH (2002) Stress and the inflammatory response: a review of neurogenic inflammation. Brain Behav Immun 16:622–653PubMedCrossRef Black PH (2002) Stress and the inflammatory response: a review of neurogenic inflammation. Brain Behav Immun 16:622–653PubMedCrossRef
4.
Zurück zum Zitat Blumenthal JA (2011) New frontiers in cardiovascular behavioral medicine: comparative effectiveness of exercise and medication in treating depression. Cleve Clin J Med 78(Suppl 1):35–43CrossRef Blumenthal JA (2011) New frontiers in cardiovascular behavioral medicine: comparative effectiveness of exercise and medication in treating depression. Cleve Clin J Med 78(Suppl 1):35–43CrossRef
5.
Zurück zum Zitat Bonnet F, Irving K, Terra JL et al (2005) Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 178:339–344PubMedCrossRef Bonnet F, Irving K, Terra JL et al (2005) Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 178:339–344PubMedCrossRef
6.
Zurück zum Zitat Bornstein SR, Schuppenies A, Wong ML et al (2006) Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions. Mol Psychiatry 11:892–902PubMedCrossRef Bornstein SR, Schuppenies A, Wong ML et al (2006) Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions. Mol Psychiatry 11:892–902PubMedCrossRef
7.
Zurück zum Zitat Carnethon MR, Biggs ML, Barzilay JI et al (2007) Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 167:802–807PubMedCrossRef Carnethon MR, Biggs ML, Barzilay JI et al (2007) Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 167:802–807PubMedCrossRef
8.
Zurück zum Zitat Carney RM, Freedland KE, Stein PK et al (2003) Effects of depression on QT interval variability after myocardial infarction. Psychosom Med 65:177–180PubMedCrossRef Carney RM, Freedland KE, Stein PK et al (2003) Effects of depression on QT interval variability after myocardial infarction. Psychosom Med 65:177–180PubMedCrossRef
9.
Zurück zum Zitat Carney RM, Freedland KE, Veith RC et al (1999) Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease. Biol Psychiatry 45:458–463PubMedCrossRef Carney RM, Freedland KE, Veith RC et al (1999) Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease. Biol Psychiatry 45:458–463PubMedCrossRef
10.
Zurück zum Zitat Carney RM, Howells WB, Blumenthal JA et al (2007) Heart rate turbulence, depression, and survival after acute myocardial infarction. Psychosom Med 69:4–9PubMedCrossRef Carney RM, Howells WB, Blumenthal JA et al (2007) Heart rate turbulence, depression, and survival after acute myocardial infarction. Psychosom Med 69:4–9PubMedCrossRef
11.
Zurück zum Zitat Deuschle M, Weber B, Colla M et al (1998) Effects of major depression, aging and gender upon calculated diurnal free plasma cortisol concentrations: a re-evaluation study. Stress 2:281–287PubMedCrossRef Deuschle M, Weber B, Colla M et al (1998) Effects of major depression, aging and gender upon calculated diurnal free plasma cortisol concentrations: a re-evaluation study. Stress 2:281–287PubMedCrossRef
12.
Zurück zum Zitat Frasure-Smith N, Lesperance F, Talajic M (1993) Depression following myocardial infarction. Impact on 6-month survival. JAMA 270:1819–1825PubMedCrossRef Frasure-Smith N, Lesperance F, Talajic M (1993) Depression following myocardial infarction. Impact on 6-month survival. JAMA 270:1819–1825PubMedCrossRef
13.
Zurück zum Zitat Gehi A, Haas D, Pipkin S et al (2005) Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Arch Intern Med 165:2508–2513PubMedCrossRef Gehi A, Haas D, Pipkin S et al (2005) Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Arch Intern Med 165:2508–2513PubMedCrossRef
14.
Zurück zum Zitat Glassman AH, O’connor CM, Califf RM et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 288:701–709PubMedCrossRef Glassman AH, O’connor CM, Califf RM et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 288:701–709PubMedCrossRef
15.
Zurück zum Zitat Gold PW, Wong ML, Goldstein DS et al (2005) Cardiac implications of increased arterial entry and reversible 24-h central and peripheral norepinephrine levels in melancholia. Proc Natl Acad Sci U S A 102:8303–8308PubMedCrossRef Gold PW, Wong ML, Goldstein DS et al (2005) Cardiac implications of increased arterial entry and reversible 24-h central and peripheral norepinephrine levels in melancholia. Proc Natl Acad Sci U S A 102:8303–8308PubMedCrossRef
16.
Zurück zum Zitat Golden SH, Lazo M, Carnethon M et al (2008) Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299:2751–2759PubMedCrossRef Golden SH, Lazo M, Carnethon M et al (2008) Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299:2751–2759PubMedCrossRef
17.
Zurück zum Zitat Holsboer F (2000) The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 23:477–501PubMedCrossRef Holsboer F (2000) The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 23:477–501PubMedCrossRef
18.
Zurück zum Zitat Howren MB, Lamkin DM, Suls J (2009) Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 71:171–186PubMedCrossRef Howren MB, Lamkin DM, Suls J (2009) Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 71:171–186PubMedCrossRef
19.
Zurück zum Zitat Kemp AH, Quintana DS, Gray MA et al (2010) Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol Psychiatry 67:1067–1074PubMedCrossRef Kemp AH, Quintana DS, Gray MA et al (2010) Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol Psychiatry 67:1067–1074PubMedCrossRef
20.
Zurück zum Zitat Kleiger RE, Miller JP, Bigger JT Jr et al (1987) Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 59:256–262PubMedCrossRef Kleiger RE, Miller JP, Bigger JT Jr et al (1987) Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 59:256–262PubMedCrossRef
21.
Zurück zum Zitat Ladwig KH, Marten-Mittag B, Lowel H et al (2005) C-reactive protein, depressed mood, and the prediction of coronary heart disease in initially healthy men: results from the MONICA-KORA Augsburg Cohort Study 1984–1998. Eur Heart J 26:2537–2542PubMedCrossRef Ladwig KH, Marten-Mittag B, Lowel H et al (2005) C-reactive protein, depressed mood, and the prediction of coronary heart disease in initially healthy men: results from the MONICA-KORA Augsburg Cohort Study 1984–1998. Eur Heart J 26:2537–2542PubMedCrossRef
22.
Zurück zum Zitat Lesperance F, Frasure-Smith N, Koszycki D et al (2007) Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 297:367–379PubMedCrossRef Lesperance F, Frasure-Smith N, Koszycki D et al (2007) Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 297:367–379PubMedCrossRef
23.
Zurück zum Zitat Licht CM, De Geus EJ, Van Dyck R et al (2010) Longitudinal evidence for unfavorable effects of antidepressants on heart rate variability. Biol Psychiatry 68:861–868PubMedCrossRef Licht CM, De Geus EJ, Van Dyck R et al (2010) Longitudinal evidence for unfavorable effects of antidepressants on heart rate variability. Biol Psychiatry 68:861–868PubMedCrossRef
24.
Zurück zum Zitat Lippi G, Montagnana M, Favaloro EJ et al (2009) Mental depression and cardiovascular disease: a multifaceted, bidirectional association. Semin Thromb Hemost 35:325–336PubMedCrossRef Lippi G, Montagnana M, Favaloro EJ et al (2009) Mental depression and cardiovascular disease: a multifaceted, bidirectional association. Semin Thromb Hemost 35:325–336PubMedCrossRef
25.
Zurück zum Zitat Luppino FS, De Wit LM, Bouvy PF et al (2010) Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 67:220–229PubMedCrossRef Luppino FS, De Wit LM, Bouvy PF et al (2010) Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 67:220–229PubMedCrossRef
26.
Zurück zum Zitat Mathers C, Loncar D (2006) Projections of global mortality and burden of disease from to 2030. PLoS Med 3:e442PubMedCrossRef Mathers C, Loncar D (2006) Projections of global mortality and burden of disease from to 2030. PLoS Med 3:e442PubMedCrossRef
27.
Zurück zum Zitat Nicholson A, Kuper H, Hemingway H (2006) Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J 27:2763–2774PubMedCrossRef Nicholson A, Kuper H, Hemingway H (2006) Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J 27:2763–2774PubMedCrossRef
28.
Zurück zum Zitat O’donnell MJ, Xavier D, Liu L et al (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 376:112–123CrossRef O’donnell MJ, Xavier D, Liu L et al (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 376:112–123CrossRef
29.
Zurück zum Zitat Otte C, Neylan TC, Pipkin SS et al (2005) Depressive symptoms and 24-hour urinary norepinephrine excretion levels in patients with coronary disease: findings from the Heart and Soul Study. Am J Psychiatry 162:2139–2145PubMedCrossRef Otte C, Neylan TC, Pipkin SS et al (2005) Depressive symptoms and 24-hour urinary norepinephrine excretion levels in patients with coronary disease: findings from the Heart and Soul Study. Am J Psychiatry 162:2139–2145PubMedCrossRef
30.
Zurück zum Zitat Pan A, Sun Q, Okereke OI et al (2011) Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA 306:1241–1249PubMedCrossRef Pan A, Sun Q, Okereke OI et al (2011) Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA 306:1241–1249PubMedCrossRef
31.
Zurück zum Zitat Rugulies R (2002) Depression as a predictor for coronary heart disease. a review and meta-analysis. Am J Prev Med 23:51–61PubMedCrossRef Rugulies R (2002) Depression as a predictor for coronary heart disease. a review and meta-analysis. Am J Prev Med 23:51–61PubMedCrossRef
32.
Zurück zum Zitat Ruo B, Rumsfeld JS, Hlatky MA et al (2003) Depressive symptoms and health-related quality of life: the Heart and Soul Study. JAMA 290:215–221PubMedCrossRef Ruo B, Rumsfeld JS, Hlatky MA et al (2003) Depressive symptoms and health-related quality of life: the Heart and Soul Study. JAMA 290:215–221PubMedCrossRef
33.
Zurück zum Zitat Serebruany VL, Glassman AH, Malinin AI et al (2003) Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis 14:563–567PubMedCrossRef Serebruany VL, Glassman AH, Malinin AI et al (2003) Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis 14:563–567PubMedCrossRef
34.
Zurück zum Zitat Taylor CB, Youngblood ME, Catellier D et al (2005) Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry 62:792–798PubMedCrossRef Taylor CB, Youngblood ME, Catellier D et al (2005) Effects of antidepressant medication on morbidity and mortality in depressed patients after myocardial infarction. Arch Gen Psychiatry 62:792–798PubMedCrossRef
35.
Zurück zum Zitat Thombs BD, Bass EB, Ford DE et al (2006) Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 21:30–38PubMedCrossRef Thombs BD, Bass EB, Ford DE et al (2006) Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 21:30–38PubMedCrossRef
36.
Zurück zum Zitat Thorndike AN, Regan S, Mckool K et al (2008) Depressive symptoms and smoking cessation after hospitalization for cardiovascular disease. Arch Intern Med 168:186–191PubMedCrossRef Thorndike AN, Regan S, Mckool K et al (2008) Depressive symptoms and smoking cessation after hospitalization for cardiovascular disease. Arch Intern Med 168:186–191PubMedCrossRef
37.
Zurück zum Zitat Van Melle JP, De Jonge P, Spijkerman TA et al (2004) Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med 66:814–822CrossRef Van Melle JP, De Jonge P, Spijkerman TA et al (2004) Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med 66:814–822CrossRef
38.
Zurück zum Zitat Van Reedt Dortland AK, Giltay EJ, Van Veen T et al (2010) Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use. Acta Psychiatr Scand 122:30–39 Van Reedt Dortland AK, Giltay EJ, Van Veen T et al (2010) Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use. Acta Psychiatr Scand 122:30–39
39.
Zurück zum Zitat Von Kanel R, Bellingrath S, Kudielka BM (2009) Association of vital exhaustion and depressive symptoms with changes in fibrin D-dimer to acute psychosocial stress. J Psychosom Res 67:93–101CrossRef Von Kanel R, Bellingrath S, Kudielka BM (2009) Association of vital exhaustion and depressive symptoms with changes in fibrin D-dimer to acute psychosocial stress. J Psychosom Res 67:93–101CrossRef
40.
Zurück zum Zitat Vreeburg SA, Hoogendijk WJ, Van Pelt J et al (2009) Major depressive disorder and hypothalamic-pituitary-adrenal axis activity: results from a large cohort study. Arch Gen Psychiatry 66:617–626PubMedCrossRef Vreeburg SA, Hoogendijk WJ, Van Pelt J et al (2009) Major depressive disorder and hypothalamic-pituitary-adrenal axis activity: results from a large cohort study. Arch Gen Psychiatry 66:617–626PubMedCrossRef
41.
Zurück zum Zitat Whooley MA (2006) Depression and cardiovascular disease: healing the broken-hearted. JAMA 295:2874–2881PubMedCrossRef Whooley MA (2006) Depression and cardiovascular disease: healing the broken-hearted. JAMA 295:2874–2881PubMedCrossRef
42.
Zurück zum Zitat Whooley MA, De Jonge P, Vittinghoff E et al (2008) Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 300:2379–2388PubMedCrossRef Whooley MA, De Jonge P, Vittinghoff E et al (2008) Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 300:2379–2388PubMedCrossRef
43.
Zurück zum Zitat Wulsin LR, Singal BM (2003) Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med 65:201–210PubMedCrossRef Wulsin LR, Singal BM (2003) Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med 65:201–210PubMedCrossRef
44.
Zurück zum Zitat Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952PubMedCrossRef Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952PubMedCrossRef
Metadaten
Titel
Depression: Risikofaktor für kardiovaskuläre Erkrankungen
verfasst von
L.K. Kuehl
B.W.J.H. Penninx
C. Otte
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
Der Nervenarzt / Ausgabe 11/2012
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-012-3584-8

Weitere Artikel der Ausgabe 11/2012

Der Nervenarzt 11/2012 Zur Ausgabe

Mitteilungen der DGPPN

Mitteilungen der DGPPN 11/2012

Übersichten

Essstörungen

CME Zertifizierte Fortbildung

Achtsamkeitsbasierte Psychotherapie

Editorial

PSYCHOSOMATIK

Neu in den Fachgebieten Neurologie und Psychiatrie