Depression and ischemic heart disease

Major depression is a common comorbidity associated with ischemic heart dis ease (IHD). There is growing evidence that psychological stress in general and depression in particular predispose to cardiovascular disease. Persons who have mental stress during daily life are at twice the risk of myocardia l ischemia, and patients with post-myocardial infarction depression have hi gher mortality rates than nondepressed controls. These data suggest a psych ophysiologic mechanism underlying the vulnerability of depressed patients t o IHD. Clinical studies have demonstrated that depression is associated wit h a much higher risk of both cardiovascular morbidity and mortality, which could be caused by platelet activation. Physicians should maintain a height ened level of clinical suspicion for depression and depressive disorders in persons with IHD, particularly those individuals who are recovering from a n acute ischemic event, such as myocardial infarction. Furthermore, depress ion may complicate the recovery of IHD, but in most cases depression can be effectively treated with antidepressant agents.