Bradley Steven M, Rumsfeld John S
Department of Veterans Affairs, VA Eastern Colorado Health Care System, Denver, CO; Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO; Colorado Cardiovascular Outcomes Research Consortium, Denver, CO.
Department of Veterans Affairs, VA Eastern Colorado Health Care System, Denver, CO; Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO; Colorado Cardiovascular Outcomes Research Consortium, Denver, CO.
Trends Cardiovasc Med. 2015 Oct;25(7):614-22. doi: 10.1016/j.tcm.2015.02.002. Epub 2015 Feb 12.
There is a wealth of evidence linking depression to increased risk for cardiovascular disease (CVD) and worse outcomes among patients with known CVD. In addition, there are safe and effective treatments for depression. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with CVD. In this review, we first summarize the evidence linking depression to increased risk of CVD and worse patient outcomes. We then review the mechanisms by which depression may contribute to cardiovascular risk and poor cardiovascular outcomes. We then summarize prior studies of depression treatment on cardiovascular outcomes. Finally, we offer guidance in the identification and management of depression among CVD populations. Given that 1 in 4 CVD patients has concurrent depression, application of these best-practices will assist providers in achieving optimal outcomes for their CVD patients.
有大量证据表明，抑郁症与心血管疾病（CVD）风险增加以及已知患有CVD的患者预后较差有关。此外，有安全有效的抑郁症治疗方法。尽管如此，抑郁症在有CVD风险或患有CVD的患者中仍未得到充分认识和治疗。在本综述中，我们首先总结将抑郁症与CVD风险增加和患者预后较差联系起来的证据。然后，我们回顾抑郁症可能导致心血管风险和不良心血管预后的机制。接着，我们总结先前关于抑郁症治疗对心血管预后影响的研究。最后，我们为CVD人群中抑郁症的识别和管理提供指导。鉴于四分之一的CVD患者同时患有抑郁症，应用这些最佳实践将有助于医疗服务提供者为其CVD患者实现最佳预后。
