Depression and Medication Adherence in Outpatients With Coronary Heart Disease

Top Cited Papers
Open Access
Publisher Website
Google Scholar
Abstract
Major depression is an established risk factor for morbidity and mortality in patients with coronary heart disease (CHD).1-11 Recently, psychosocial factors, such as depression, have been identified as 1 of 9 modifiable risk factors, along with diabetes mellitus, smoking, and hypertension, that account for more than 90% of the risk of myocardial infarction worldwide.12 Several biological factors have been considered as potential mechanisms by which depression may lead to cardiac events, including increased sympathetic tone,13,14 increased catecholamine levels,15 increased cortisol levels,16 increased platelet activation, increased levels of inflammatory mediators,17 and antidepressant drug reactions.18 However, nonadherence to important cardiac prevention and treatment recommendations may also be associated with depression and could contribute to the increased risk of CHD events in depressed patients.19