Published: 19-06-2024 06:00 | Updated: 19-06-2024 15:16

The connection between depression and cardiovascular disease

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Researchers at the Institute of Environmental Medicine (IMM) have published two studies on the connection between depression and cardiovascular disease. The first study explores the physiological mechanisms behind the link between general depression and cardiovascular disease. The second examines the increased risk of cardiovascular disease in women affected by perinatal depression. The results emphasize the importance of understanding and treating depression to prevent serious physical illness.

Depression increases the risk of cardiovascular disease

The study shows that individuals with depression have an increased risk of suffering from cardiovascular diseases. In addition, genetic, physiological, and social factors that explain the increased risk are described. Previous studies have shown an increased risk of cardiovascular disease in individuals affected by depression, but the underlying factors for the connection have been unknown.

Jacob Bergstedt, IMM

In the current study, researchers have investigated genes linked to the risk of depression as well as genes linked to the risk of cardiovascular diseases. By using innovative methods that integrate such information, it has been shown that almost all risk genes for cardiovascular disease are also risk genes for depression and that common risk genes are linked to gene expression in blood vessels and the thalamus region of the brain. Furthermore, the researchers show that the link between depression and cardiovascular disease can be explained by behavioral and psychosocial factors such as smoking and loneliness, but also observe that metabolic factors such as unhealthy fat composition play an important role.

Jacob Bergstedt, postdoctoral researcher at the Institute for Environmental Medicine and first author of the study comments:

- Our study provides an increased understanding of the connection between depression and cardiovascular diseases and shows the importance of understanding depression and other mental illnesses from a physiological perspective. The results also provide insights that may lead to new and improved methods for treating depression and reducing the risk of cardiovascular disease in individuals suffering from mental illness.

Feelings of loneliness, smoking, and even to some extent an unhealthy fat composition are all related to chronic tissue inflammation. Therefore, the results point to the importance of chronic inflammation in the link between depression and cardiovascular disease. The next step in the research is to use data from measured levels of inflammatory protein and metabolites in the blood of a large number of people to investigate with a high resolution physiological mechanisms that explain the link between depression and cardiovascular disease. Such an analysis can identify molecules that are candidates for a potential drug intervention.

The study is based on large international collaborations.

Perinatal depression and cardiovascular disease in women

For years, cardiovascular research has primarily focused on men, leading to well-known risk factors such as high cholesterol and smoking. However, women’s heart health has often been overlooked, especially concerning unique female experiences like pregnancy and childbirth.

Emma Bränn, IMM

The study, published in the European Heart Journal, utilized Sweden’s comprehensive registers to track the cardiovascular health outcomes of women in the following 20 years after being diagnosed with depression during pregnancy or postpartum, namely perinatal depression (PND). The findings indicate that women with PND have a 36 % higher risk of developing CVD compared to those without PND, after adjusting for other factors including common risk factors for CVD.

Emma Bränn, postdoctoral researcher at the Institute of Environmental Medicine, explains:

- Our study suggests that the experience of PND may have long-term implications for a woman’s cardiovascular health. It’s crucial that we integrate mental health into our understanding of reproductive history when assessing CVD risk.

Donghao Lu, IMM

Interestingly, the association between PND and CVD was most pronounced in women without psychiatric comorbidities, suggesting that PND itself is a significant risk factor. Dr. Donghao Lu, the first author, comments: 

- These findings underscore the need for healthcare providers to consider PND not just as a temporary mental health issue but as a marker of potential long-term physical health risks.

The study opens up new avenues for understanding and preventing heart disease in women. 

Publications

Distinct genomic signatures and modifiable risk factors underly the comorbidity between major depressive disorder and cardiovascular disease.
Bergstedt J, Pasman JA, Ma Z, Harder A, Yao S, Parker N, Treur JL, Smit DJA, Frei O, Shadrin A, Meijsen JJ, Shen Q, Hägg S, Tornvall P, Buil A, Werge T, Hjerling-Leffler J, Als TD, Børglum AD, Lewis CM, McIntosh AM, Valdimarsdóttir UA, Andreassen OA, Sullivan PF, Lu Y, Fang F
Nature Cardiovascular Research

Perinatal depression and maternal cardiovascular risk: a Swedish nationwide study
Donghao Lu, Unnur A Valdimarsdóttir, Dang Wei, Yufeng Chen, Ole A Andreassen, Fang Fang, Krisztina D László, Emma Bränn
European Heart Journal