The relationship between depression and coronary heart disease- the importance of depression as a prognostic factor

Chronic coronary artery disease is one of the most common cardiovascular diseases. A significant percentage of people in today's society suffer from depression. Data from the literature demonstrates the relationship between depression and ischaemic coronary heart disease, especially in women. Depression has been shown to be an independent risk factor for cardiovascular events, being reported in 1 in 5 patients with coronary heart disease and 1 in 3 patients with heart failure. Neuroendocrine mechanisms, including autonomic nervous system response, blood cortisol levels, catecholamine secretion and many others underlie this phenomenon. Each patient reacts differently to mental stress, some may develop Takotusbo syndrome, also known as broken heart syndrome. Depression in patients with coronary heart disease is a risk factor that increases mortality, decreases adherence to treatment and quality of life. There is a bidirectional relationship between depression and cardiovascular disease, meaning that coronary heart disease can lead to depression and depression is an independent risk factor for coronary heart disease and its complications and can contribute to sudden cardiac death. In this article we aim to bring together data from the literature linking depression and coronary heart disease, bringing to light common risk factors for early diagnosis and optimal management in order to improve cardiovascular outcomes.