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Association between major depression and cardiovascular risk: the role of antidepressant medication

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Abstract

Rationale and objectives

Major depressive disorder (MDD) is associated with an increased risk for cardiovascular disease (CVD). Apart from biological and life style factors, the use of antidepressants and their potentially adverse effects might contribute to the increased CVD risk. Therefore, we compared cardiovascular risk profiles between relatively young depressed patients without CVD with and without antidepressant medication and healthy participants.

Methods

We investigated 44 depressed patients (with antidepressants N = 20 (13 women), mean age 43.2 years; without antidepressants N = 24 (15 women), mean age 40.0) and 41 healthy participants (matched for sex, age, education). As markers of CVD risk, blood pressure, body mass index (BMI), and plasma levels of fasting glucose, cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and high sensitivity C-reactive protein (h-CRP) were measured.

Results

We found significant differences between groups for BMI (p < .01), systolic (p = .02) and diastolic blood pressure (p < .01), and glucose (p < .001). Post hoc analyses indicated differences between both patient groups compared to the healthy control group, but not between patients groups. Further controlling for BMI diminished the effect of diagnosis on blood pressure; however, this was not the case for glucose level. There were no between-group differences in cholesterol, LDL, HDL, and h-CRP.

Conclusions

We found a clearly increased CVD risk in this group of rather young depressed patients. Importantly, there was no significant difference in CVD risk between patients with vs. without antidepressants. This suggests that major depression per se and not antidepressant medication is associated with increased CVD risk.

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Acknowledgments

The authors received no funding. Dr. LK, Dr. CM, Dr. KH, Dr. LD, Dr. KW, and Dr. CS report no conflict of interest. Dr. CO has received honoria fees for lectures from Lundbeck and Servier.

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    Authors and Affiliations

    1. Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany

      Linn K. Kuehl, Kim Hinkelmann, Katja Wingenfeld & Christian Otte

    2. Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

      Christoph Muhtz

    3. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

      Lucia Dettenborn

    4. Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany

      Carsten Spitzer

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    1. Linn K. Kuehl
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    Correspondence to Linn K. Kuehl.

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    The study was carried out in accordance with the latest version of the Declaration of Helsinki and approved by the responsible local ethics committee (ethics committee of the Medical Association of Hamburg). Informed consent of the participants was obtained after the nature of the procedures had been fully explained.

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    Linn K. Kuehl and Christoph Muhtz contributed equally to this work.

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    Kuehl, L.K., Muhtz, C., Hinkelmann, K. et al. Association between major depression and cardiovascular risk: the role of antidepressant medication. Psychopharmacology 233, 3289–3295 (2016). https://doi.org/10.1007/s00213-016-4361-3

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