Association of depressive symptoms with reduced baroreflex cardiac controlin coronary artery disease

Background Although depression has been associated with cardiac death in co ronary artery disease (CAD), little is known about the effects of depressio n on autonomic nervous system control of heart rate. This study evaluated w hether depressive symptomatology is associated with impaired baroreflex sen sitivity (BRS) in patients with CAD. Methods and Results BRS was assessed in 66 patients with stable CAD by usin g cross-spectral analysis to measure baroreceptor-mediated R-R interval osc illations. Depressive symptomatology was determined with the Beck Depressio n Inventory, with lower (scores <3, n = 14) and upper (scores >9, n = 16) q uartiles of scores used to define groups with low and high depressive sympt omatology, respectively. Comparison of the two groups showed that age-adjus ted BRS was reduced in the patients with high depressive symptomatology whe n compared with patients with low depressive symptomatology (4.5 +/- 2.7 vs 6.5 +/- 2.8 ms/mm Hg; P < .05). Conclusions The current findings show that patients with CAD and depressive symptomatology have reduced BRS. Future studies are needed to examine whet her reduced baroreflex cardiac control predicts cardiac risk in patients wi th CAD and depressive symptomatology.