Ischemic Heart Disease with Depression

Abstract

Depression is highly prevalent in patients with ischemic heart disease, and the presence of depression increases the risk of mortality. Mechanisms underlying cardiovascular disease and depression include health-related behavior and biological factors such as autonomic nervous system functioning, platelet activity, endothelial dysfunction, and inflammation. Antipsychotics such as SSRIs are the first line treatment for patients with coronary heart disease and moderate or severe depression. Previous studies have shown that antidepressants and cognitive behavioral therapy are safe and effective to improve depressive symptoms of patients with coronary heart disease, but significant improvements in cardiovascular outcomes or mortality of the patients have not been observed yet. Several recent studies suggest that collaborative care improves both depressive symptoms and cardiovascular outcomes. In 2008, the American Heart Association formally recommended routine screening for clinical depression in patients with coronary heart disease. These trends suggest that it is important to establish a care network between cardiology and psychiatry.