Depression and Cardiovascular Diseases Coursework Help

Depression and Cardiovascular Diseases Coursework Writing Service

Introduction

Cardiovascular disease (CVD) and depression are common. Patients with CVD have more depression than the general population. Persons with depression are more likely to eventually develop CVD and also have a higher mortality rate than the general population. Patients with CVD, who are also depressed, have a worse outcome than those patients who are not depressed. There is a graded relationship:

Depression and Cardiovascular Diseases Coursework Writing Service

Depression and Cardiovascular Diseases Coursework Writing Service

the more severe the depression, the higher the subsequent risk of mortality and other cardiovascular events. Cardiovascular disease (CVD) and depression are currently the two most common causes of disability in high-income countries and expected to become so for countries of all income levels by The key health system and economic indicators relating to CVD and depression reveal rising medical costs, increased health service utilization, and lost productivity. Additionally, CVD and depression profoundly impact the overall quality of life, even more so for heart failure patients. One could argue that depression is probably the most important driver of overall quality of life

 This potential association received little attention for >, until Frasure-Smith and colleagues published a study demonstrating that patients who are depressed at the time of an acute myocardial infarction (MI) have markedly elevated mortality as compared with patients who are not depressed. Since then, >100 studies have investigated this relationship, providing evidence that depression is prevalent (≈20% to 35%) in populations with cardiovascular disease, is predictive of developing cardiovascular disease, and is predictive of adverse outcomes among patients with existing cardiac disease. Depression, however, remains largely off the radar screen of cardiac care, in large part because of confusion about the nature of the association between depression and cardiovascular disease and the role of cardiovascular clinicians with regard to depressed patients. In turn, persistent HPA and SA activation lead to the observed downstream abnormalities in platelet function, autonomic tone, inflammation, and endothelial function. This unifying stress-response hypothesis suggests how depression could be a direct risk factor for both the development of cardiovascular disease and the increased morbidity and mortality for patients with preexisting disease.

Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 out-patients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 out-patients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder.

Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 out-patients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 out-patients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder.

Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 out-patients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. The risk of developing depression is three times greater among patients with cardiovascular disease (CVD) than in patients without CVD, and as researchers pointed out, “a higher burden of depressive symptoms is also associated with worse cardiovascular and non cardiovascular outcomes.”

In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. Depression in cardiac disease is common, persistent, underrecognized, and deadly. Over the past 20 years, research has found that not only is depression more common in cardiac patients than in the general population, but depression is also a risk factor for cardiac morbidity and mortality, independent of traditional risk factors. This link between depression and cardiac morbidity likely involves both physiologic and behavioral effects of depression. Fortunately, screening for depression in cardiac patients is straightforward, and methods of diagnosis essentially parallel those for major depressive disorder (MDD) diagnosis in other settings. In this paper, we will review the epidemiology, course, impact, pathogenesis, and diagnostic assessment of depression in patients with cardiovascular disease (CVD).

Recent studies suggest that major depression is a risk factor not only for the development of coronary artery disease (CAD) but also for mortality among patients who have had a myocardial infarction (MI). For instance, a study by Frasure-Smith and colleagues found that among patients who had experienced a myocardial infarction, major depression increased the risk of death over the next year almost 4-fold. Similar results were reported in a long-term study by Barefoot and colleagues, lending further support to the association between depression, MI, and mortality.  It has been well documented that depression increases the risk of cardiovascular disease; on the other hand, patients with cardiovascular disease suffer from depression more frequently than the general population.

Depression is related to coronary heart disease, hypertension and stroke, and it is now recognized as an independent risk factor for cardiovascular disease Elevated plasma homocysteine levels and a low intake or reduced levels of omega-3-fatty acids are also suggested to be shared risk factors for depression and cardiovascular disease. The presence of one disease can complicate the management of the other: depressed patients with coronary heart disease show less compliance to cardiac prevention and treatment regimens. Additionally, the choice of antidepressant treatment is limited in patients with heart disease. in this issue is that depression and cardiovascular disease could be different manifestations of the same genetic substrates. Like other multifactorial and polygenic disorders, these two conditions are the result of the interaction of multiple genetic factors with the environment. The genetics of both disorders is complex, involving multiple genes with small interactive and additive effects. In spite of enormous amounts of work in the field of genetics, studies of depression and cardiovascular risk are often confounded by gene-gene and gene-environment interactions. Such interactions underlie at the molecular level the synergy between the products of various genes or between gene products and environmental factors, resulting in a greater than additive effect on risk. Genetic risk is thus modifiable in an environment-specific manner. Gene effects can amplify the effect of environmental or metabolic factors on the final phenotype rather than directly affect the risk of the disease

To examine the effect of MDD on time to cardiovascular event and adjust for confounding, we computed the amount of cardiovascular events occurring within the follow-up period in MDD participants and controls with Cox regression models. To assess whether potential confounders influenced the risk of CVD associated with depression, we included variables into the model that were significantly different at baseline and had significant bivariate associations with cardiovascular events. Data were analysed using SPSS 20 and two-tailed test α levels of <.05 were used to define statistical significance. We checked effect modification between prior CVD status and depression by adding an interaction term DISCUSSION: Depression and cardiovascular disease are both highly prevalent. Several studies have shown that the two are closely related. They share common path physiological etiologies or co-morbidities, such as alterations in the hypothalamic-pituitary axis, cardiac rhythm disturbances, and hemorheologic, inflammatory and serotoninergic changes. Furthermore, antidepressant treatment is associated with worse cardiac outcomes (in case of tricyclics), which are not observed with selective serotonin reuptake inhibitors. We selected the most relevant studies in the literature using the PubMed database, with the keywords "heart disease", "coronary disease", "depression", "cardiovascular disease" and "mood disorder". The manuscripts included in this article were selected based on their methodological aspects and the strength of their findings. We addressed this important topic comprehensively in three major areas: 1) the causal relationship between depression and CVD, 2) the pathophysiological basis for that relationship, and 3) the impact of pharmacological treatment for depression on CVD.

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Posted on January 9, 2017 in Nursing Coursework

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