Skip to main content

Advertisement

SpringerLink
Log in

The Impact of Depression and Anxiety on Cardiovascular Disease Risk and Outcomes in Women

  • Women’s Health (A Sarma, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Depression and anxiety are known to potentiate cardiovascular disease and result in worse outcomes. These disorders disproportionately affect women. The purpose of this review is to examine the impact of depression and anxiety on cardiovascular outcomes in women.

Recent Findings

Depression, anxiety, and psychosocial stressors work through a number of mechanisms to decrease health behavior engagement and increase cardiovascular risk in women. Ultimately, this leads to worsened quality of life, cardiovascular morbidity, and mortality among affected women. Notably, because these conditions are more prevalent in women, they may contribute to widening of pre-existing disparities in cardiovascular outcomes based on sex.

Summary Understanding

Depression and anxiety may contribute to impaired quality of life and increased mortality in women with cardiovascular diseases. Therefore, it is imperative for providers to screen for, recognize, and treat these conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 390, 1211–1259 (2017).

  2. McLean CP, Asnaani A, Litz B, et al. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45:1027–35.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pimple P, Lima B, Hammadah M, et al. Psychological distress and subsequent cardiovascular events in individuals with coronary artery disease. J Am Heart Assoc. 2019;8:e011866.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Jha M, Qamar A, Vaduganathan M, et al. Screening and management of depression in patients with cardiovascular disease: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73:1827–45.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Huffman J, Smith F, Blais M, et al. Recognition and treatment of depression and anxiety in patients with acute myocardial infarction. Am J Cardiol. 2006;98:319–24.

    Article  PubMed  Google Scholar 

  6. Lichtman J, Bigger T, Blumenthal J, et al. AHA science advisory. Depression and coronary heart disease. Recommendations for screening, referral, and treatment. A science advisory from the American Heart Association Prevention Committee to the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care Outcomes Research. Endorsed by the American Psychiatric Association. Prog Cardiovasc Nurs. 2009;24:19–26.

    PubMed  Google Scholar 

  7. Sharma S, Kaadan M, Duran J, et al. Risk factors, imaging findings, and sex differences in spontaneous coronary artery dissection. Am J Cardiol. 2019;123:1783–7.

    Article  PubMed  Google Scholar 

  8. Krittanawong C, Kumar A, Johnson K, et al. Conditions and factors associated with spontaneous coronary artery dissection (from a National Population-Based Cohort Study). Am J Cardiol. 2019;123:249–53.

    Article  PubMed  Google Scholar 

  9. Rosman L, Salmoirago-Blotcher E, Cahill J, et al. Psychosocial adjustment and quality of life in patients with peripartum cardiomyopathy. J Cardiovasc Nurs. 2019;34:20–8.

    Article  PubMed  Google Scholar 

  10. Potts S, Lewin R, Fox K, et al. Group psychological treatment for chest pain with normal coronary arteries. QJM. 1999;92:81–6.

    Article  CAS  PubMed  Google Scholar 

  11. Agrawal S, Mehta P, Bairey Merz CN, et al. Cardiac syndrome X: update. Heart Fail Clin. 2016;12:141–56.

    Article  PubMed  Google Scholar 

  12. Celano C, Daunis D, Lokko H, et al. Anxiety disorders and cardiovascular disease. Curr Psychiatry Rep. 2016;18:101.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Huffman J, Celano C, Beach S, et al. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013(695):925.

    Google Scholar 

  14. Miller G, Freedland K, Carney R, et al. Cynical hostility, depressive symptoms, and the expression of inflammatory risk markers for coronary heart disease. J Behav Med. 2003;26:501–15.

    Article  PubMed  Google Scholar 

  15. Gruenewald T, Cohen S, Matthews K, et al. Association of socioeconomic status with inflammation markers in black and white men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Soc Sci Med. 2009;69:451–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Newby L, et al. Inflammation as a Treatment Target after Acute Myocardial Infarction. N Engl J Med. 2019;381:2562–3.

    Article  PubMed  Google Scholar 

  17. Ridker P, MacFadyen J, Everett B, et al. Relationship of C-reactive protein reduction to cardiovascular event reduction following treatment with canakinumab: a secondary analysis from the CANTOS randomized controlled trial. Lancet. 2018;391:319–28.

    Article  CAS  PubMed  Google Scholar 

  18. Tardif J, Kouz S, Waters D, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med. 2019;381:2497–505.

    Article  CAS  Google Scholar 

  19. Tawakol A, Ishai A, Takx R, et al. Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. Lancet. 2017;389:834–45.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lu Y, Zhou S, Dreyer R, et al. Sex differences in inflammatory markers and health status among young adults with acute myocardial infarction: results from the VIRGO (variation in recovery: role of gender on outcomes of young acute myocardial infarction patients) study. Circ Cardiovasc Qual Outcomes. 2017;10:e003470.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rooks C, Ibeanu I, Shah A, et al. Young women post-MI have higher plasma concentrations of interleukin-6 before and after stress testing. Brain Behav Immun. 2016;51:92–8.

    Article  CAS  PubMed  Google Scholar 

  22. •• Sullivan S, Hammadah M, Wilmot K, et al. Young women with coronary artery disease exhibit higher concentrations of interleukin-6 at baseline and in response to mental stress. J Am Heart Assoc. 2018;7:e010329 Importance: There is a higher burden of psychosocial in young woman with coronary artery disease compared to men of a similar age. This study notes an increased level of interleukin-6, a mediator of inflammation, in response to mental stress in young woman compared to men of a similar age. This provides important mechanistic insights into how psychosocial stress can mediate deleterious cardiovascular stressors.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. •• Vaccarino V, Johnson D, Sheps D, et al. Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute-sponsored WISE study. J Am Coll Cardiol. 2007;50:2044–50 Importance: In this study, depression and inflammatory markers were predictors of cardiovascular disease in women. However, inflammatory biomarkers explained only a small percentage of that difference, suggesting that the impact of depression on cardiovascular disease is more complex.

    Article  PubMed  Google Scholar 

  24. Kop W, Stein P, Tracy R, et al. Autonomic nervous system dysfunction and inflammation contribute to the increased cardiovascular mortality risk associated with depression. Psychosom Med. 2010;72:626–35.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Voss A, Boettger M, Schulz S, et al. Gender-dependent impact of major depression on autonomic cardiovascular modulation. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35:1131–8.

    Article  Google Scholar 

  26. Huffman J, Celano C, Beach S, et al. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013(695):925.

    Google Scholar 

  27. Zipursky R, Press M, Srikanthan P, et al. Relation of stress hormones (urinary catecholamines/cortisol) to coronary artery calcium in men versus women (from the multi-ethnic study of atherosclerosis [MESA]). Am J Cardiol. 2017;119:1963–71.

    Article  CAS  PubMed  Google Scholar 

  28. Heim C, Newport D, Heit S, et al. Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA. 2000;284:592–7.

    Article  CAS  PubMed  Google Scholar 

  29. Mullen P, Martin J, Anderson J, et al. The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse Negl. 1996;20:7–21.

    Article  CAS  PubMed  Google Scholar 

  30. Dean J, Cruz S, Mehta P, et al. Coronary microvascular dysfunction: sex-specific risk, diagnosis, and therapy. Nat Rev Cardiol. 2015;12:406–14.

    Article  PubMed  Google Scholar 

  31. Gdowski M, Murthy V, Doering M, et al. Association of isolated coronary microvascular dysfunction with mortality and major adverse cardiac events: a systematic review and meta-analysis of aggregate data. J Am Heart Assoc. 2020;9:e014954.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Vaccarino V, Sullivan S, Hammadah M, et al. Mental stress-induced-myocardial ischemia in young patients with recent myocardial infarction: sex differences and mechanisms. Circulation. 2018;137:794–805.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Pimple P, Hammadah M, Wilmot K, et al. The relation of psychosocial distress with myocardial perfusion and stress-induced myocardial ischemia. Psychosom Med. 2019;81:363–71.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Vaccarino V, Wilmot K, Mheid I, et al. Sex differences in mental stress-induced myocardial ischemia in patients with coronary heart disease. J Am Heart Assoc. 2016;5.

  35. Samad Z, Boyle S, Ersboll M, et al. Sex differences in platelet reactivity and cardiovascular and psychological response to mental stress in patients with stable ischemic heart disease: insights from the REMIT study. J Am Coll Cardiol. 2014;64:1669–78.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wei J, Rooks C, Ramadan R, et al. Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease. Am J Cardiol. 2014;114:187–92.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sun J, Boyle S, Samad Z, et al. Mental stress-induced left ventricular dysfunction and adverse outcome in ischemic heart disease patients. Eur J Prev Cardiol. 2017;24:591–9.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Jiang W, Velazquez E, Kuchibhatla M, et al. Effect of escitalopram on mental stress-induced myocardial ischemia: results of the REMIT trial. JAMA. 2013;309:2139–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Blumenthal JA, et al. Usefulness of psychosocial treatment of mental stress-induced myocardial ischemia in men. Am J Cardiol. 2002;89:164–8.

    Article  PubMed  Google Scholar 

  40. Al Mheid I, Quyyumi A, et al. Sex differences in mental stress-induced myocardial ischemia: are women from venus? J Am Coll Cardiol. 2014;64:1679–80.

    Article  PubMed  Google Scholar 

  41. Schlienger R, Meier C, et al. Effect of selective serotonin reuptake inhibitors on platelet activation. Am J Cardiovasc Drugs. 2003;3:149–62.

    Article  CAS  PubMed  Google Scholar 

  42. Musselman D, Tomer A, Manatunga A, et al. Exaggerated platelet reactivity in major depression. Am J Psychiatry. 1996;153:1313–7.

    Article  CAS  PubMed  Google Scholar 

  43. Zafar M, Paz-Yepes M, Shimbo D, et al. Anxiety is a better predictor of platelet reactivity in coronary artery disease patients than depression. Eur Heart J. 2010;31:1573–82.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Mauler M, Herr N, Schoenichen C, et al. Platelet serotonin aggravates myocardial ischemia/reperfusion injury via neutrophil degranulation. Circulation. 2019;139:918–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Ranucci M, Aloisio T, Di Dedda U, et al. Gender-based differences in platelet function and platelet reactivity to P2Y12 inhibitors. PLoS One. 2019;14:e0225771.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Snoep J, Roest M, Barendrecht A, et al. High platelet reactivity is associated with myocardial infarction in premenopausal women: a population-based case-control study. J Thromb Haemost. 2010;8:906–13.

    Article  CAS  PubMed  Google Scholar 

  47. Dawood T, Barton D, Lambert E, et al. Examining endothelial function and platelet reactivity in patients with depression before and after SSRI therapy. Front Psychiatry. 2016;7(18).

  48. Aleksovski B, Naceva V, Vujovic V, et al. SSRI-reduced platelet reactivity in non-responding patients with life-long recurrent depressive disorder: detection and involved mechanisms. Thromb Res. 2018;165:24–32.

    Article  CAS  PubMed  Google Scholar 

  49. Sporinova B, Manns B, Tonelli M, et al. Association of mental health disorders with health care utilization and costs among adults with chronic disease. JAMA Netw Open. 2019;2:e199910.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Lee G, Kim H, Jung S, et al. Association between depression and disease-specific treatment. J Affect Disord. 2020;260:124–30.

    Article  PubMed  Google Scholar 

  51. Palacios J, Khondoker M, Mann A, et al. Depression and anxiety symptom trajectories in coronary heart disease: associations with measures of disability and impact on 3-year health care costs. J Psychosom Res. 2018;104:1–8.

    Article  PubMed  Google Scholar 

  52. Iturralde E, Chi F, Grant R, et al. Association of anxiety with high-cost health care use among individuals with type 2 diabetes. Diabetes Care. 2019;42:1669–74.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Hohls J, Wild B, Heider D, et al. Association of generalized anxiety symptoms and panic with health care costs in older age-results from the ESTHER cohort study. J Affect Disord. 2019;245:978–86.

    Article  CAS  PubMed  Google Scholar 

  54. Cramer H, Lauche R, Adams J, et al. Is depression associated with unhealthy behaviors among middle-aged and older women with hypertension or heart disease? Womens Health Issues. 2020;30:35–40.

    Article  PubMed  Google Scholar 

  55. Rutledge T, Kenkre T, Thompson D, et al. Depression, dietary habits, and cardiovascular events among women with suspected myocardial ischemia. Am J Med. 2014;127:840–7.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Serpytis P, Navickas P, Lukaviciute L, et al. Gender-based differences in anxiety and depression following acute myocardial infarction. Arq Bras Cardiol. 2018;111:676–83.

    PubMed  PubMed Central  Google Scholar 

  57. Matta J, Hoertel N, Kasse-Guyot E, et al. Diet and physical activity in the association between depression and metabolic syndrome: constances study. J Affect Disord. 2019;244:25–32.

    Article  PubMed  Google Scholar 

  58. Lee G, Kim H, Jung S, et al. Association between depression and disease-specific treatment. J Affect Disord. 2020;260:124–30.

    Article  PubMed  Google Scholar 

  59. Szpakowski N, Bennell M, Qiu F, et al. Clinical Impact of subsequent depression in patients with a new diagnosis of stable angina: a population-based study. Circ Cardiovasc Qual Outcomes. 2016;9:731–9.

    Article  PubMed  Google Scholar 

  60. Smolderen K, Strait K, Dreyer R, et al. Depressive symptoms in younger women and men with acute myocardial infarction: insights from the VIRGO study. J Am Heart Assoc. 2015;4.

  61. Smolderen K, Spertus J, Gosch K, et al. Depression treatment and health status outcomes in young patients with acute myocardial infarction: insights from the VIRGO study (variation in recovery: role of gender on outcomes of young ami patients). Circulation. 2017;135:1762–4.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Parashar S, Rumsfeld J, Reid K, et al. Impact of depression on sex differences in outcome after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2009;2:33–40.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Mallik S, Spertus J, Reid K, et al. Depressive symptoms after acute myocardial infarction: evidence for highest rates in younger women. Arch Intern Med. 2006;166:876–83.

    Article  PubMed  Google Scholar 

  64. Shah A, Ghasemzadeh N, Zaragoza-Macias E, et al. Sex and age differences in the association of depression with obstructive coronary artery disease and adverse cardiovascular events. J Am Heart Assoc. 2014;3:e000741.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Mehta L, Beckie T, DeVon H, et al. Acute myocardial infarction in women: a scientific statement from the American Heart Association. Circulation. 2016;133:916–47.

    Article  CAS  PubMed  Google Scholar 

  66. Whang W, Kubzansky L, Kawachi I, et al. Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses’ Health Study. J Am Coll Cardiol. 2009;53:950–8.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Guimarães P, Granger C, Stebbins A, et al. Sex differences in clinical characteristics, psychosocial factors, and outcomes among patients with stable coronary heart disease: insights from the STABILITY (stabilization of atherosclerotic plaque by initiation of darapladib therapy) Trial. J Am Heart Assoc. 2017;6.

  68. Ellins E, Shipley M, Rees D, et al. Associations of depression-anxiety and dyslipidaemia with subclinical carotid arterial disease: findings from the Whitehall II Study. Eur J Prev Cardiol. 2020;27:800–7.

    Article  PubMed  Google Scholar 

  69. Munyombwe T, Hall M, Dondo T, et al. Quality of life trajectories in survivors of acute myocardial infarction: a national longitudinal study. Heart. 2020;106:33–9.

    Article  PubMed  Google Scholar 

  70. Koh Y, Stehli J, Martin C, et al. Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study. BMJ Open. 2019;9:e034034.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Saelee R, Vaccarino V, Sullivan S, et al. Longitudinal associations between self-reported experiences of discrimination and depressive symptoms in young women and men post- myocardial infarction. J Psychosom Res. 2019;124(109):782.

    Google Scholar 

  72. Xu X, Bao H, Strait K, et al. Sex differences in perceived stress and early recovery in young and middle-aged patients with acute myocardial infarction. Circulation. 2015;131:614–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Rich-Edwards MS, Rexrode K, et al. Physical and sexual abuse in childhood as predictors of early-onset cardiovascular events in women. Circulation. 2012;126:920–7.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Korkeila J, Vahtera J, Korkeila K, et al. Childhood adversities as predictors of incident coronary heart disease and cerebrovascular disease. Heart. 2010;96:298–303.

    Article  PubMed  Google Scholar 

  75. Rutledge T, Reis V, Linke S, et al. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48:1527–37.

    Article  PubMed  Google Scholar 

  76. Müller-Tasch T, Frankenstein L, Holzapfel N, et al. Panic disorder in patients with chronic heart failure. J Psychosom Res. 2008;64:299–303.

    Article  PubMed  Google Scholar 

  77. Celano C, Villegas A, Albanese A, et al. Depression and anxiety in heart failure: a review. Harv Rev Psychiatry. 2018;26:175–84.

    Article  PubMed  PubMed Central  Google Scholar 

  78. McGrady A, McGinnis R, Badenhop D, et al. Effects of depression and anxiety on adherence to cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2009;29:358–64.

    Article  PubMed  Google Scholar 

  79. Daskalopoulou M, George J, Walters K, et al. Depression as a risk factor for the initial presentation of twelve cardiac, cerebrovascular, and peripheral arterial diseases: data linkage study of 1.9 million women and men. PLoS One. 2016;11:e0153838.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Roy S, Foraker R, Girton R, et al. Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans. Am J Public Health. 2015;105:757–63.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Garfield L, Scherrer J, Huaptman P, et al. Association of anxiety disorders and depression with incident heart failure. Psychosom Med. 2014;76:128–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Gustad L, Laugsand L, Janszky I, et al. Symptoms of anxiety and depression and risk of heart failure: the HUNT Study. Eur J Heart Fail. 2014;16:861–70.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Meyer S, van der Meer P, Massie B, et al. Sex-specific acute heart failure phenotypes and outcomes from PROTECT. Eur J Heart Fail. 2013;15:1374–81.

    Article  PubMed  Google Scholar 

  84. Maslov P, Kim J, Argulian E, et al. Is cardiac diastolic dysfunction a part of post-menopausal syndrome? JACC Heart Fail. 2019;7:192–203.

    Article  PubMed  Google Scholar 

  85. Lam C, Arnott C, Beale A, et al. Sex differences in heart failure. Eur Heart J. 2019;40:3859–3868c.

    Article  PubMed  Google Scholar 

  86. Haedtke C, Moser D, Pressler S, et al. Influence of depression and gender on symptom burden among patients with advanced heart failure: insight from the pain assessment, incidence and nature in heart failure study. Heart Lung. 2019;48:201–7.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Heo S, McSweeney J, Tsai P, et al. Differing effects of fatigue and depression on hospitalizations in men and women with heart failure. Am J Crit Care. 2016;25:526–34.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Jiang W, Krishnan R, Kuchibhatla M, et al. Characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study). Am J Cardiol. 2011;107:545–51.

    Article  PubMed  PubMed Central  Google Scholar 

  89. de Chazal H, Del Buono M, Keyser-Marcus L, et al. Stress cardiomyopathy diagnosis and treatment. J Am Coll Cardiol. 2018;72:1955–71.

    Article  PubMed Central  Google Scholar 

  90. Templin C, Ghadri J, Diekmann J, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373:929–38.

    Article  CAS  PubMed  Google Scholar 

  91. Deshmukh A, Kumar G, Pant S, et al. Prevalence of Takotsubo cardiomyopathy in the United States. Am Heart J. 2012;164:66–71.e1.

    Article  PubMed  Google Scholar 

  92. Keramida K, Backs J, Bossone E, et al. Takotsubo syndrome in heart failure and world congress on acute heart failure 2019: highlights from the experts. ESC Heart Fail. 2020;7:400–6.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Pelliccia F, Parodi G, Greco C, et al. Comorbidities Frequency in Takotsubo syndrome: an international collaborative systematic review including 1109 patients. Am J Med. 2015;128(654):e11–9.

    Article  PubMed  Google Scholar 

  94. Vidi V, Rajesh V, Singh P, et al. Clinical characteristics of tako-tsubo cardiomyopathy. Am J Cardiol. 2009;104:578–82.

    Article  PubMed  Google Scholar 

  95. Nayeri A, et al. Pre-existing Psychiatric illness is associated with increased risk of recurrent Takotsubo cardiomyopathy. Psychosomatics. 2017;58:527–32.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Auger N, Paradis G, Healy-Profitós J, He S, Potter BJ. Outcomes of Takotsubo syndrome at 15 years: a matched cohort study. Am J Med. 2020;133:627–634.e4.

    Article  PubMed  Google Scholar 

  97. Lazzeroni D, et al. Anxiety disorders and stressful events in Takotsubo syndrome. Cardiol J. 2018;25:495–500.

    Article  PubMed  Google Scholar 

  98. Nayeri A, Rafla-Yuan E, Farber-Eger E, et al. Psychiatric illness in Takotsubo (Stress) cardiomyopathy: a review. Psychosomatics. 2018;59:220–6.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Moulig V, Pfeffer T, Ricke-Hoch M, et al. Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities. Eur J Heart Fail. 2019;21:1534–42.

    Article  CAS  PubMed  Google Scholar 

  100. Rosman L, Salmoirago-Blotcher E, Cahill J, et al. Psychosocial adjustment and quality of life in patients with peripartum cardiomyopathy. J Cardiovasc Nurs. 2019;34:20–8.

    Article  PubMed  Google Scholar 

  101. Patel H, Berg M, Barasa A, et al. Symptoms in women with peripartum cardiomyopathy: a mixed method study. Midwifery. 2016;32:14–20.

    Article  PubMed  Google Scholar 

  102. Liang J, Tweet M, Hayes S, et al. Prevalence and predictors of depression and anxiety among survivors of myocardial infarction due to spontaneous coronary artery dissection. J Cardiopulm Rehabil Prev. 2014;34:138–42.

    Article  PubMed  Google Scholar 

  103. Saw J, Starovoytov A, Birnie T, et al. Comparison of psychosocial questionnaires between spontaneous coronary artery dissection (SCAD) and non-scad populations undergoing cardiac rehabilitation program after myocardial infarction. J Am Coll Cardiol. 2016;67:1936.

    Article  Google Scholar 

  104. Saw J, Aymong E, Sedlak T, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circ Cardiovasc Interv. 2014;7:645–55.

    Article  PubMed  Google Scholar 

  105. Fahmy P, Prakash R, Starovoytov A, et al. Pre-disposing and precipitating factors in men with spontaneous coronary artery dissection. JACC Cardiovasc Interv. 2016;9:866–8.

    Article  PubMed  Google Scholar 

  106. Johnson A, Hayes S, Sawchuk C, et al. Analysis of posttraumatic stress disorder, depression, anxiety, and resiliency within the unique population of spontaneous coronary artery dissection survivors. J Am Heart Assoc. 2020;9:e014372.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Pasupathy S, Tavella R, Beltrame J, et al. Myocardial Infarction with nonobstructive coronary arteries (MINOCA): the past, present, and future management. Circulation. 2017;135:1490–3.

    Article  PubMed  Google Scholar 

  108. Tamis-Holland J, Jneid H, Reynolds H, et al. Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association. Circulation. 2019;139:e891–908.

    Article  PubMed  Google Scholar 

  109. Pelliccia F, Pasceri V, Niccoli G et al. Predictors of mortality in myocardial infarction and nonobstructed coronary arteries: a systematic review and meta-regression. Am J Med 133, 73–83.e4 (2020).

  110. Daniel M, Agewall S, Berglund F, et al. Prevalence of anxiety and depression symptoms in patients with myocardial infarction with non-obstructive coronary arteries. Am J Med. 2018;131:1118–24.

    Article  PubMed  Google Scholar 

  111. Gu X, He C, Shen L, et al. Association between depression and outcomes in Chinese patients with myocardial infarction and nonobstructive coronary arteries. J Am Heart Assoc. 2019;8:e011180.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Mosca L, Grundy S, Judelson D, et al. AHA/ACC scientific statement: consensus panel statement. Guide to preventive cardiology for women. American Heart Association/American College of Cardiology. J Am Coll Cardiol. 1999;33:1751–5.

    CAS  PubMed  Google Scholar 

  113. Mensah G, Wei G, Sorlie P, et al. Decline in cardiovascular mortality: possible causes and implications. Circ Res. 2017;120:366–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Ramya C. Mosarla MD

  2. Corrigan Women’s Heart Health Program, Boston, MA, USA

    Malissa Wood MD

Authors
  1. Ramya C. Mosarla MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Malissa Wood MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ramya C. Mosarla MD.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Women's Health

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mosarla, R.C., Wood, M. The Impact of Depression and Anxiety on Cardiovascular Disease Risk and Outcomes in Women. Curr Treat Options Cardio Med 23, 10 (2021). https://doi.org/10.1007/s11936-020-00889-9

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11936-020-00889-9

Keywords

Search

Navigation