Interação bidirecional entre depressão e doenças cardiovasculares
DOI:
https://doi.org/10.5281/zenodo.15075621Palavras-chave:
Depressão, Doenças cardiovasculares, Relação bidirecional, Fatores de riscoResumo
Este estudo teve como objetivo explorar os mecanismos fisiopatológicos e as implicações clínicas da relação bidirecional entre depressão e doenças cardiovasculares (DCV), com foco nos fatores biológicos, comportamentais e psicossociais envolvidos. Por meio de uma revisão integrativa da literatura, elaborada em seis etapas, realizou-se uma busca nas bases LILACS, MEDLINE e PubMed, utilizando a estratégia PEO. Foram incluídos estudos publicados entre 2020 e 2024, totalizando 13 artigos após triagem rigorosa. Os resultados destacaram que depressão foi associada a um aumento significativo no risco de eventos cardiovasculares, como infarto agudo do miocárdio e acidente vascular cerebral, com hazard ratios (HR) variando de 1,22 a 1,69. Mecanismos como inflamação sistêmica, disfunção endotelial e desregulação do eixo hipotálamo-hipófise-adrenal foram identificados como mediadores dessa relação. Paralelamente, indivíduos com DCV apresentaram maior predisposição a desenvolver depressão, especialmente devido ao impacto psicossocial da doença. Diferenças de gênero e idade foram marcantes, com mulheres e adultos jovens (<65 anos) mostrando maior vulnerabilidade. Fatores genéticos compartilhados e comportamentos de risco (sedentarismo, tabagismo) amplificaram a relação bidirecional. Portanto, a relação entre depressão e DCV é bidirecional e mediada por fatores biológicos, comportamentais e psicossociais, de modo que a identificação precoce de sintomas depressivos e a implementação de estratégias integradas de prevenção e tratamento são essenciais para mitigar riscos e melhorar desfechos clínicos. Limitações incluem a predominância de estudos observacionais e a sub-representação de populações rurais e de baixa renda. Dessa forma, futuras pesquisas devem priorizar desenhos longitudinais e ensaios clínicos para testar intervenções personalizadas.
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