Background Major depressive disorder has been identified as a risk factor for cardiovascular disease （CVD）. The underlying mechanisms linking depression and CVD are not fully understood, one of the mechanisms in wom...Background Major depressive disorder has been identified as a risk factor for cardiovascular disease （CVD）. The underlying mechanisms linking depression and CVD are not fully understood, one of the mechanisms in women is disturbed cortisol regulation. The aim of this study was to evaluate cortisol rhythm in suspected female CVD patients with depression. Methods A total of 80 female patients with suspected CVD （typical angina pectoris or under a non-typical symptoms plus positive exercise tests or positive myocardial perfusion scans） were recruited. Four blood samples for cortisal were taken over the day and night. Depression was assessed using the Beck Depression Inventory （BDI）. Results Forty-three （53.8 %） patients were diagnosed as definite CVD on angiography,while the remainder did not. Cortisol showed a typical diurnal pattern, with peaks in the morning and low down in the evening. The cortisol slope over the day was flatter in depressed patients with CVD （P 0.01）, but was not related to depression in patients without CVD （P = 0.096）. This effect was due to the combination of lower cortisol early in the day and higher cortisol in the evening in more depressed CVD patients, independent of age, education, household income, marital status, living alone and and sleeping. Comparison of cortisol secretion rhythm in total patients between the CVD group and non-CVD group, BDI≥10 group and BDI 10 group, the differences were not significant （P 0.05）. Conclusions The flat cortisol rhythms of depressive CVD patients may be associated with the progression of CVD in women.展开更多
文摘Background Major depressive disorder has been identified as a risk factor for cardiovascular disease （CVD）. The underlying mechanisms linking depression and CVD are not fully understood, one of the mechanisms in women is disturbed cortisol regulation. The aim of this study was to evaluate cortisol rhythm in suspected female CVD patients with depression. Methods A total of 80 female patients with suspected CVD （typical angina pectoris or under a non-typical symptoms plus positive exercise tests or positive myocardial perfusion scans） were recruited. Four blood samples for cortisal were taken over the day and night. Depression was assessed using the Beck Depression Inventory （BDI）. Results Forty-three （53.8 %） patients were diagnosed as definite CVD on angiography,while the remainder did not. Cortisol showed a typical diurnal pattern, with peaks in the morning and low down in the evening. The cortisol slope over the day was flatter in depressed patients with CVD （P 0.01）, but was not related to depression in patients without CVD （P = 0.096）. This effect was due to the combination of lower cortisol early in the day and higher cortisol in the evening in more depressed CVD patients, independent of age, education, household income, marital status, living alone and and sleeping. Comparison of cortisol secretion rhythm in total patients between the CVD group and non-CVD group, BDI≥10 group and BDI 10 group, the differences were not significant （P 0.05）. Conclusions The flat cortisol rhythms of depressive CVD patients may be associated with the progression of CVD in women.
