Research reportDepression and vascular disease: what is the relationship?
Section snippets
Depression and vascular disease: what is the relationship?
There has been great interest in the relationship of depressive illness to vascular disease, although the idea has a long history, with Post (1972) observing that many elderly people with depression showed evidence of associated vascular disease. The term ‘vascular depression’ was proposed by Alexopoulos et al. (1997) who suggested it should cover a range of late-life depressive syndromes due to a variety of potential vascular mechanisms. Krishnan et al. (1997) agreed to adopt this terminology,
Studies examining vascular disease in pre-existing depression
Three kinds of study (clinical, neuroimaging and neuropathology) have investigated whether vascular disease, especially cerebrovascular disease, is increased in people with depression.
Studies of depression in pre-existing vascular disease
Many studies have demonstrated an increase in the prevalence of depression in vascular diseases, especially coronary artery disease (CAD) and stroke disease.
Prospective studies of vascular disease and depression
Several prospective studies have examined the impact of depression at baseline on the development of subsequent vascular disease. These reports will be briefly reviewed to examine the relationship between CAD, stroke disease and blood pressure; there appear to be no studies for vascular dementia.
Conclusion
There is convincing evidence from a variety of studies demonstrating that depression and vascular disease are intimately related, especially in the elderly. Vascular disease is increased in depression, vascular diseases are associated with an increased prevalence of depressive illness and depression in an independent risk factor for CAD and stroke. This relationship appears most likely to be bi-directional and there are plausible mechanisms which can explain it in both directions. The concept
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