Interacción bidireccional entre depresión y enfermedad cardiovascular
DOI:
https://doi.org/10.5281/zenodo.15075621Palabras clave:
Depresión, Enfermedades cardiovasculares, Relación bidireccional, Factores de riesgoResumen
Este estudio tuvo como objetivo explorar los mecanismos fisiopatológicos y las implicaciones clínicas de la relación bidireccional entre la depresión y las enfermedades cardiovasculares (ECV), centrándose en los factores biológicos, conductuales y psicosociales involucrados. A través de una revisión integradora de la literatura, elaborada en seis etapas, se realizó una búsqueda en las bases de datos LILACS, MEDLINE y PubMed, utilizando la estrategia PEO. Se incluyeron estudios publicados entre 2020 y 2024, totalizando 13 artículos tras un riguroso cribado. Los resultados destacaron que la depresión se asociaba con un aumento significativo en el riesgo de eventos cardiovasculares, como infarto agudo de miocardio y accidente cerebrovascular, con índices de riesgo (HR) que oscilaban entre 1,22 y 1,69. Mecanismos como la inflamación sistémica, la disfunción endotelial y la desregulación del eje hipotalámico-pituitario-adrenal se han identificado como mediadores de esta relación. Al mismo tiempo, las personas con ECV tenían más probabilidades de desarrollar depresión, especialmente debido al impacto psicosocial de la enfermedad. Las diferencias de género y edad fueron sorprendentes, siendo las mujeres y los adultos jóvenes (<65 años) los que mostraron una mayor vulnerabilidad. Los factores genéticos compartidos y las conductas de riesgo (estilo de vida sedentario, tabaquismo) amplificaron la relación bidireccional. Por tanto, la relación entre depresión y ECV es bidireccional y está mediada por factores biológicos, conductuales y psicosociales, por lo que la identificación temprana de los síntomas depresivos y la implementación de estrategias integradas de prevención y tratamiento son esenciales para mitigar los riesgos y mejorar los resultados clínicos. Las limitaciones incluyen el predominio de estudios observacionales y la subrepresentación de las poblaciones rurales y de bajos ingresos. Por lo tanto, las investigaciones futuras deberían priorizar los diseños longitudinales y los ensayos clínicos para probar intervenciones personalizadas.
Referencias
AGUILERA, A. et al. mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE Study. BMJ Open, [s. l.], v. 10, n. 8, p. e034723, 2020. DOI: 10.1136/bmjopen-2019-034723.
ALJUHANI, H. et al. Food habits and associated risk factors of depressed patients with cardiovascular disease. PLoS ONE, [s. l.], v. 17, n. 2, p. 1-13, 2022. DOI: 10.1371/journal.pone.0263519.
BARGER, S. D.; STRUVE, G. C. Association of Depression With 10-Year and Lifetime Cardiovascular Disease Risk Among US Adults, National Health and Nutrition Examination Survey, 2005–2018. Preventive Chronic Disease, [s. l.], v. 19, p. e28, 2022. DOI: 10.5888/pcd19.210418.
BONNET, F. et al. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis, [s. l.], v. 178, n. 2, p. 339-344, 2005. DOI: 10.1016/J.ATHEROSCLEROSIS.2004.08.035.
CHAPLIN, A. B. et al. Longitudinal association between cardiovascular risk factors and depression in young people: a systematic review and meta-analysis of cohort studies. Psychological Medicine, [s. l.], v. 53, n. 3, p. 1049-1059, 2021. DOI: 10.1017/S0033291721002488.
CHEN, X. et al. Depression Status, Lifestyle, and Metabolic Factors With Subsequent Risk for Major Cardiovascular Events: The China Cardiometabolic Disease and Cancer Cohort (4C) Study. Frontiers in Cardiovascular Medicine, [s. l.], v. 9, p. 865063, 2022. DOI: 10.3389/fcvm.2022.865063.
DRIVA, S. et al. The Effect of Smoking Cessation on Body Weight and Other Metabolic Parameters with Focus on People with Type 2 Diabetes Mellitus. International Journal of Environmental Research and Public Health, [s. l.], v. 19, n. 20, p. 13222, 2022. DOI: 10.3390/ijerph192013222.
ESLER, M. Mental stress and human cardiovascular disease. Neuroscience & Biobehavioral Reviews, [s. l.], v. 74, p. 269-276, 2017. DOI: 10.1016/j.neubiorev.2016.10.011.
FRĄK, W. et al. Pathophysiology of cardiovascular diseases: New insights into molecular mechanisms of atherosclerosis, arterial hypertension, and coronary artery disease. Biomedicines, [s. l.], v. 10, n. 8, p. 1-17, 2022. DOI: 10.3390/biomedicines10081938.
GÓMEZ-GÓMEZ, I. et al. Effectiveness of universal multiple-risk lifestyle interventions in reducing depressive symptoms: Systematic review and meta-analysis. Preventive Medicine, [s. l.], v. 134, p. 106067, 2020. DOI: 10.1016/j.ypmed.2020.106067.
HARSHFIELD, E. L. et al. Association Between Depressive Symptoms and Incident Cardiovascular Diseases. JAMA, [s. l.], v. 324, n. 23, p. 2396-2405, 2020. DOI: 10.1001/jama.2020.23068.
HENEIN, M. et al. The impact of mental stress on cardiovascular health—Part II. Journal of Clinical Medicine, [s. l.], v. 11, n. 15, p. 1-17, 2022. DOI: 10.3390/jcm11154405.
HU, X. et al. Effect of a multidisciplinary supportive program for family caregivers of patients with heart failure on caregiver burden, quality of life, and depression: A randomized controlled study. International Journal of Nursing Studies, [s. l.], v. 62, p. 11-21, 2016.DOI: 10.1016/j.ijnurstu.2016.07.006.
KANG, S. et al. Association between depressive symptoms and cardiovascular diseases in the Korean geriatric population: A nationwide retrospective cohort study. Journal of Affective Disorders, [s. l.], v. 361, p. 182-188, 2024. DOI: 10.1016/j.jad.2024.06.022.
KWAPONG, Y. A. et al. Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States. Journal of the American Heart Association, [s. l.], v. 12, n. 3, p. e028332, 2023. DOI: 10.1161/JAHA.122.028332.
LETT, H. et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosomatic Medicine, [s. l.], v. 66, n. 2, p. 305-315, 2004. DOI: 10.1097/01.PSY.0000126207.43307.C0.
LI, G. H. Y. et al. Evaluation of bi-directional causal association between depression and cardiovascular diseases: a Mendelian randomization study. Psychological Medicine, [s. l.], v. 52, n. 9, p. 1765-1776, 2022. DOI: 10.1017/S0033291720003566.
LI, H. et al. Association of depressive symptoms with incident cardiovascular diseases in middle-aged and older Chinese adults. JAMA Network Open, [s. l.], v. 2, n. 12, p. e1916591, 2019. DOI: 10.1001/jamanetworkopen.2019.16591.
LOPIZZO, N. et al. Gene-environment interaction in major depression: focus on experience-dependent biological systems. Frontiers in Psychiatry, [s. l.], v. 6, p. 68, 2015. DOI: 10.3389/fpsyt.2015.00068.
LU, Y. et al. Genetic Liability to Depression and Risk of Coronary Artery Disease, Myocardial Infarction, and Other Cardiovascular Outcomes. Journal of the American Heart Association, [s. l.], v. 10, n. 1, p. e017986, 2020. DOI: 10.1161/JAHA.120.017986.
MENG, R. et al. Association between Depression and All-cause and Cardiovascular Mortality in Chinese Adults. JAMA Network Open, [s. l.], v. 3, n. 2, p. e1921043, 2020. DOI: 10.1001/jamanetworkopen.2019.21043.
MOUTON, A. M. et al. Obesity, Hypertension, and Cardiac Dysfunction: Novel Roles of Immunometabolism in Macrophage Activation and Inflammation. Circulation Research, [s. l.], v. 126, n. 6, p. 789-806, 2020. DOI: 10.1161/CIRCRESAHA.119.312321.
OGUNMOROTI, O. et al. A systematic review of the bidirectional relationship between depressive symptoms and cardiovascular health. Preventive Medicine, [s. l.], v. 154, p. 106891, 2021. DOI: 10.1016/j.ypmed.2021.106891.
PENNINX, B. Depression and cardiovascular disease: Epidemiological evidence on their linking mechanisms. Neuroscience & Biobehavioral Reviews, [s. l.], v. 74, p. 277-286, 2017. DOI: 10.1016/j.neubiorev.2016.07.003.
RAFANELLI, C. et al. Sequential combination of cognitive-behavioral treatment and well-being therapy in depressed patients with acute coronary syndromes: A randomized controlled trial (TREATED-ACS study). Psychotherapy and Psychosomatics, [s. l.], v. 89, p. 345-356, 2020. DOI: 10.1159/000510006.
RIERA-SAMPOL, A. et al. Association between Depression, Lifestyles, Sleep Quality, and Sense of Coherence in a Population with Cardiovascular Risk. Nutrients, [s. l.], v. 13, n. 2, p. 585, 2021. DOI: 10.3390/nu13020585.
SHEN, R. et al. Association between level of depression and coronary heart disease, stroke risk and all-cause and cardiovascular mortality: Data from the 2005–2018 National Health and Nutrition Examination Survey. Frontiers in Cardiovascular Medicine, [s. l.], v. 9, p. 954563, 2022. DOI: 10.3389/fcvm.2022.954563.
STRINGARIS, A. Editorial: What is depression?. Journal of Child Psychology and Psychiatry, [s. l.], v. 58, n. 12, p. 1287-1289, 2017. DOI: 10.1111/jcpp.12844.
TANG, A.; THOMAS, S. Relationships between depressive symptoms, other psychological symptoms, and quality of life. Psychiatry Research, [s. l.], v. 289, 2020. DOI: 10.1016/j.psychres.2020.113049.
THAKUR, B. et al. Sex Differences in the Association of Depression Symptoms and Cardiovascular Disease in Adults in the United States. American Journal of Health Promotion, [s. l.], v. 38, n. 8, p. 1199-1209, 2024. DOI: 10.1177/08901171241262249.
TORGERSEN, K. et al. Shared genetic loci between depression and cardiometabolic traits. PLoS Genetics, [s. l.], v. 18, n. 5, p. e1010161, 2022. DOI: 10.1371/journal.pgen.1010161.
YU, L. et al. Association Between Depression and Risk of Incident Cardiovascular Diseases and Its Sex and Age Modifications: A Prospective Cohort Study in Southwest China. Frontiers in Public Health, [s. l.], v. 10, p. 765183, 2022. DOI: 10.3389/fpubh.2022.765183.
ZAJKOWSKA, Z. et al. A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression. Journal of Psychiatric Research, [s. l.], v. 138, p. 163-175, 2021. DOI: 10.1016/j.jpsychires.2021.04.003.
WARD, A. Symptoms of depression: Charles G. Costello (Ed.): Wiley, New York (1993). x + 326 pp. £29.95. Behaviour Research and Therapy, [s. l.], v. 33, n. 5, p. 615, 1995. DOI: 10.1016/0005-7967(95)90121-3.
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