Abstract
Background
Coronary heart disease is a major cause of mortality in women and persons with diabetes. Mental stress and major depressive
disorder have both been associated with coronary heart disease. Endothelial functioning is a clinically meaningful manifestation
of CHD that is detectable in its earliest stages.
disorder have both been associated with coronary heart disease. Endothelial functioning is a clinically meaningful manifestation
of CHD that is detectable in its earliest stages.
Methods
Resting endothelial function was assessed for n = 215 postmenopausal women with no known or suspected coronary artery disease participated. Of these, 108 had a positive
lifetime major depressive disorder (L-MDD; assessed through structured clinical interview) and had been free of major depressive
disorder for >6 months; 103 had type 2 diabetes. Endothelial reactivity to acute mental stress was assessed for n = 114 of the participants. Endothelial function was assessed by flow-mediated dilation of the brachial artery (FMD) by total
plasma nitrite, the cumulative molecule from nitric oxide (NO) generation, and by plasma endothelin-1 (ET-1).
lifetime major depressive disorder (L-MDD; assessed through structured clinical interview) and had been free of major depressive
disorder for >6 months; 103 had type 2 diabetes. Endothelial reactivity to acute mental stress was assessed for n = 114 of the participants. Endothelial function was assessed by flow-mediated dilation of the brachial artery (FMD) by total
plasma nitrite, the cumulative molecule from nitric oxide (NO) generation, and by plasma endothelin-1 (ET-1).
Results
Participants with L-MDD had lower NO and lower FMD compared to never-depressed controls. Secondary analyses suggest that among
participants with L-MDD, antidepressant medications are associated with higher NO. Participants with diabetes had higher NO
but lower FMD than nondiabetic controls. Mental stress affected FMD in the entire sample. Diabetes moderated the effect of
mental stress on NO and L-MDD moderated the effect of mental stress on ET-1.
participants with L-MDD, antidepressant medications are associated with higher NO. Participants with diabetes had higher NO
but lower FMD than nondiabetic controls. Mental stress affected FMD in the entire sample. Diabetes moderated the effect of
mental stress on NO and L-MDD moderated the effect of mental stress on ET-1.
- Content Type Journal Article
- Pages 1-9
- DOI 10.1007/s12529-011-9190-5
- Authors
- Julie A. Wagner, Department of Behavioral Sciences and Community Health MC3910, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06410, USA
- Howard Tennen, Department of Community Medicine, University of Connecticut Health Center, Farmington, CT, USA
- Patrick H. Finan, Department of Psychology, Arizona State University, Phoenix Metropolitan Area, AZ, USA
- William B. White, Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT, USA
- Matthew M. Burg, Columbia University, New York, NY, USA
- Nimrta Ghuman, Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT, USA
- Journal International Journal of Behavioral Medicine
- Online ISSN 1532-7558
- Print ISSN 1070-5503