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February 1, 2009Cleveland Clinic Journal of Medicine174 citationsOpen Access

Depression and heart rate variability in patients with coronary heart disease

RCRobert M. CarneyKFKenneth E. Freedland

Key Result

Low heart rate variability may account for a substantial part of the increased mortality risk associated with depression in patients with coronary heart disease.

Structured PICO

Is depression associated with lower heart rate variability in patients with coronary heart disease?

P
Population
Patients with coronary heart disease (stable CHD and recent acute coronary event)
I
Intervention
Depression
C
Comparator
Nondepressed counterparts
O
Outcome
Heart rate variability (HRV)surrogate

Depression in patients with coronary heart disease is associated with lower heart rate variability, which may partially explain their increased risk of cardiac morbidity and mortality.

Limitations

  • Causality between depression, low heart rate variability, and mortality is not definitively proven.
  • More work is needed to clarify the physiologic and behavioral mechanisms underlying depression's role as a risk factor.

Abstract

Depression is common in patients with coronary heart disease (CHD) and is a risk factor for cardiac morbidity and mortality in these patients. Depression is associated with autonomic nervous system dysfunction, which may at least partially explain this increased risk. Low heart rate variability (HRV), which reflects excessive sympathetic and/or inadequate parasympathetic modulation of heart rate, is a strong predictor of mortality in patients with CHD. Most studies-both in patients with stable CHD and in patients with a recent acute coronary event-have found HRV to be lower in depressed patients than in their nondepressed counterparts. This manuscript provides an overview of this literature and concludes that HRV may account for a substantial part of the risk associated with depression in CHD.

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Cite This Study

Carney et al. (2009) conducted a review in Coronary heart disease and depression. Low heart rate variability may account for a substantial part of the increased mortality risk associated with depression in patients with coronary heart disease.

synapsesocial.com/papers/6a1afb0177ec05d9a7b90169https://doi.org/10.3949/ccjm.76.s2.03
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