Common Pathophysiological Mechanisms of Depression and CardiovascularDiseases
Psychiatrická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Raboch, DrSc.
Čes. a slov. Psychiat., , 2004, No. 6, pp. 360-367.
Depressive disorder and cardiovascular diseases have common pathophysiological mechanisms.They include both biological and behavioral mechanisms. The principal biological mechanismsare: the activation of hypothalamo-pitutio-adrenal axis with increased activation of sympatheticnervous system, decreased vagal tonus followed by decreased heart rate variability and thechanges in thrombogenesis with increased thrombocytic agregability. These three mechanismsare followed by the cascade of other processes, which are interconnected with each other, they aremutually inseparable and cause the damage of cardiovascular system. These fi ndings are importantfor clinical praxis. Patients who suffer nontreated depressive disorder have a higher risk ofdevelopment of cardiovascular diseases than the depressive patients treated with antidepressantsincluding the tricyclic ones, which have the potential risk of cardiotoxicity. Hopeful is using the SSRIantidepressants, which have the benign cardiovascular profi le. The conclusion includes the necessityto establish the diagnosis of the depressive disorder and than to treat it to prevent the patient’ssuicide and also to decrease the risk of development of the cardiovascular diseases.
depressive disorder, cardiovascular diseases, pathophysiological mechanisms,cardiotoxicity
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