EMGO Institute for Health and Care Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Biol Psychiatry. 2011 Apr 15;69(8):795-803. doi: 10.1016/j.biopsych.2010.12.034. Epub 2011 Feb 21.
Arterial stiffness gains attention as a potential mechanism underlying the frequently found association between depression or anxiety and cardiovascular disease. However, observations regarding stiffness and psychopathology were often based on small samples. The current study aimed to examine whether subjects with a diagnosis of depressive or anxiety disorder showed increased stiffness and to explore associations between various psychiatric characteristics and arterial stiffness.
The sample included 449 cases with DSM-IV based lifetime diagnoses of depressive and/or anxiety disorder and 169 control subjects. Subjects were participating in the Netherlands Study of Depression and Anxiety and were aged 20 to 66 years. Characteristics included comorbidity, subtype of disorder, symptom severity and duration, age of onset, and use of antidepressant medication. Arterial stiffness was measured by calibrated radial tonometry (heart rate normalized central augmentation index [AIx75]; in percentage) and carotid M-mode ultrasound (distensibility coefficient).
After adjustment for covariates, AIx75 was increased in current (1-month) depression or anxiety (15.7% vs. 13.3% in control subjects, p = .01). Disorder characteristics associated with AIx75 were depression and anxiety comorbidity (15.3%, p = .02), higher depression severity (β = .10, p < .001) and anxiety severity (β = .10, p < .001), and longer symptom duration (β = .07, p = .01). No significant associations were found between distensibility coefficient and psychopathology.
Current depressive or anxiety disorders were associated with a higher central augmentation index, a manifestation of early wave reflection because of arterial stiffness. Exposure to depression and anxiety may therefore enhance the development and progression of atherosclerosis and other cardiovascular conditions.
动脉僵硬度作为抑郁或焦虑与心血管疾病之间常见关联的潜在机制引起了关注。然而，关于僵硬度和精神病理学的观察结果通常基于小样本。本研究旨在检查是否诊断为抑郁或焦虑障碍的患者存在僵硬度增加，并探讨各种精神病理学特征与动脉僵硬度之间的关系。
该样本包括 449 例基于 DSM-IV 的终生诊断为抑郁和/或焦虑障碍的病例和 169 例对照。研究对象参加了荷兰抑郁和焦虑研究，年龄在 20 至 66 岁之间。特征包括共病、障碍亚型、症状严重程度和持续时间、发病年龄和抗抑郁药物的使用。动脉僵硬度通过校准的桡动脉张力测量法（心率归一化中心增强指数[AIx75]；以百分比表示）和颈动脉 M 模式超声（可扩张性系数）进行测量。
在调整协变量后，当前（1 个月）抑郁或焦虑（15.7%比对照组 13.3%，p =.01）的 AIx75 增加。与 AIx75 相关的障碍特征包括抑郁和焦虑共病（15.3%，p =.02）、更高的抑郁严重程度（β =.10，p <.001）和焦虑严重程度（β =.10，p <.001），以及更长的症状持续时间（β =.07，p =.01）。未发现 distensibility coefficient 与精神病理学之间存在显著相关性。
当前的抑郁或焦虑障碍与更高的中心增强指数相关，这是动脉僵硬度导致早期波反射的表现。因此，暴露于抑郁和焦虑可能会增强动脉粥样硬化和其他心血管疾病的发展和进展。
