A recent study investigated whether stress and depression were associated with endothelial dysfunction in adults.
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. Many well-known risk factors of CVD have been identified, including high blood pressure, lipid imbalance, diabetes, and smoking. In addition to these, researchers have also identified several social, environmental, and psychological factors that can regulate heart health. For instance, the INTERHEART study, which included data from 52 countries found that psychosocial stress was independently associated with an increased risk of heart attacks. The exact mechanism by which stress regulates heart health, however, remains unknown. One theory is that stress contributes to endothelial dysfunction, which can negatively affect blood vessel function and worsen cardiac health. Long-term or repeated exposure to stress can contribute to major depressive disorder, which itself is a non-traditional risk factor for CVD.
A group from Penn State recently published an article in the Journal of the American Heart Association, investigating the relationship between stress, depression, and endothelial function. A total of 43 participants without CVD were recruited, of which 23 were diagnosed with major depressive disorder. On the day of the experiment, each participant was asked to report whether they had been exposed to any stressful event over the last 24 hours. Next, endothelial function was assessed by injecting a drug called acetylcholine via a fiber under each participant’s arm. Acetylcholine is a neurotransmitter in the body that can act on blood vessels to induce dilation.
The link between stress and depression
The study found that adults with depression reported a higher number of stressful events and rated them as being more severe, compared to non-depressed controls. Exposure to stress was associated with significant endothelial dysfunction in depressed adults only, and not in non-depressed adults. These studies show that while depression itself may be negatively linked to heart health; these adverse effects could be exacerbated further by stressful events. Overall, the study provides evidence of a link between stress, depression, and endothelial dysfunction, and underlines the importance of psychological factors that might play a crucial role in heart health. These findings could be used as a rationale for teaching adults with major depressive disorder stress coping techniques in order to improve their day-to-day quality of life and to reduce the risk of cardiovascular disease.
Written by Haisam Shah, BSc
Reference: Greaney, J. L., Koffer, R. E., Saunders, E. F., Almeida, D. M., & Alexander, L. M. (2019). Self‐Reported Everyday Psychosocial Stressors Are Associated With Greater Impairments in Endothelial Function in Young Adults With Major Depressive Disorder. Journal of the American Heart Association, 8(4), e010825.