Acute Ischemic Heart DiseaseAssociation of anxiety with reduced baroreflex cardiac control in patients after acute myocardial infarction*,**,★
Section snippets
Patients
Patients were invited to participate in this study if they showed evidence of AMI based on a greater than twofold increase in cardiac enzymes with either somatic symptoms or electrocardiographic changes characteristic of AMI (ST-segment changes or new Q waves). All patients were tested while taking their prescribed medications. Patients were excluded if they were not currently in normal sinus rhythm or if they were unable to complete the required diagnostic interview because of severe physical
Effects of depression diagnosis
Eighteen percent of the patients with AMI met the modified criteria for MDD. Clinical and demographic characteristics of patients with MDD and those without MDD are shown in Table I.Empty Cell Patients without depression Patients with depression N 167 37 Sex 58% Men 60% Men Race 62% White 76% White Age (y) 59 ± 11 56 ± 13 BDI score 7 ± 6 21 ± 10*** State anxiety score 31 ± 10 40 ± 12*** BMI (kg/m2) 28.3 ± 5.2 30.9 ± 10.9* Current smokers 53% 81%** SBP (mm Hg) 126 ± 20 123 ± 15
Discussion
We found no evidence for a relationship between depression and impaired autonomic control in patients with AMI. These findings are similar to those in studies of depressed psychiatric patients that did not find a relationship between depressive symptoms and heart rate variability12, 13, 14 or BRS.15 However, other studies in psychiatric patients41, 42 and in patients with stable CAD9, 10 have observed lower levels of heart rate variability and lower BRS11 in depressed patients compared with
Acknowledgements
We thank Dr Norman Anderson for providing the Finapres blood pressure monitor used in this study. We also thank Drs Elizabeth Jackson, Virginia Wadley, and Teri Baldewicz for confirming the diagnoses of MDD in the patients.
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Cited by (0)
- *
Guest Editor for this manuscript was Mark A. Hlatky, MD, Stanford University School of Medicine, Stanford, Calif.
- **
This study was supported by funds from the National Institutes of Health (Grants U01-HL58946-04, HL-60826, HL-59672, and HC-55142).
- ★
Reprint requests: Dr Lana Watkins, Department of Psychiatry and Behavioral Sciences, Box 3119, Duke University Medical Center, Durham, NC 27710. E-mail: [email protected]