Cardiovascular Effects of Depression and Stress
Summary
Depression and chronic stress are now recognised as independent risk factors for cardiovascular morbidity and mortality worldwide. Psychological distress alters autonomic balance, favouring sympathetic predominance and reduced vagal tone, which in turn elevates heart rate, blood pressure and arrhythmic vulnerability. Prolonged activation of the hypothalamic-pituitary-adrenal axis raises circulating cortisol and catecholamines, promoting endothelial dysfunction, inflammation and a prothrombotic state. Behavioural changes, including poor adherence to medications, sedentary lifestyle and unhealthy diet, further compound vascular injury. At the myocardial level, stress-related neurohormonal surges drive maladaptive remodelling and fibrosis, increasing the risk of heart failure after ischaemic injury. Globally, recognition of psycho-cardiological interactions has prompted integrated care models, combining psychological interventions, lifestyle modification and targeted anti-inflammatory strategies to reduce the burden of heart disease in vulnerable populations.
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Cardiovascular Effects of Depression and Stress publication trend
The graph below shows the total number of articles in cardiovascular effects of depression and stress across all publications each year (not limited to Nature Index journals).
Technical terms
Autonomic nervous system: Division of the nervous system controlling involuntary physiological functions, with sympathetic and parasympathetic branches.
Hypothalamic-pituitary-adrenal (HPA) axis: Neuroendocrine system regulating stress response through cortisol release.
Endothelial dysfunction: Impaired ability of blood vessels to dilate and maintain antithrombotic balance.
Neuroinflammation: Activation of immune cells in the brain, such as microglia, leading to cytokine production and neuronal changes.
Myocardial remodelling: Structural and functional changes in the heart muscle following injury, often resulting in fibrosis and impaired contractility.
References
- Shuangxinfang Prevents S100A9-Induced Macrophage/Microglial Inflammation to Improve Cardiac Function and Depression-Like Behavior in Rats After Acute Myocardial Infarction. Frontiers in Pharmacology (2022).
- Ginkgo Biloba Extract Reduces Cardiac and Brain Inflammation in Rats Fed a HFD and Exposed to Chronic Mental Stress through NF‐κB Inhibition. Mediators of Inflammation (2022).
- Association of cardiovascular health with cognitive function and the mediating effect of depressive state. Frontiers in Aging Neuroscience (2024).
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