Journal of Immigrant and Minority Health

, Volume 17, Issue 4, pp 1259–1276 | Cite as

Depression in Cardiovascular Patients in Middle Eastern Populations: A Literature Review

  • Tam Truong DonnellyEmail author
  • Jassim Mohd Al Suwaidi
  • Awad Al-Qahtani
  • Nidal Asaad
  • Najlaa Abdul Qader
  • Rajvir Singh
  • Tak Shing Fung
  • Irem Mueed
  • Shima Sharara
  • Noha El Banna
  • Sarah Omar
Review Paper


Cardiovascular disease (CVD) is increasing in Middle Eastern countries. Depression is associated with increased morbidity and mortality rates among cardiovascular (CV) patients. Early detection of and intervention for depression among CV patients can reduce morbidity and mortality and save health care costs. Public information on mental health care needs of Arab CV patients living in Middle East regions is scattered and limited. This literature review surveyed and summarized research studies to learn what is known about the relationship between depression and CVD in Middle Eastern populations. The information will raise awareness among health care professionals and policy makers regarding the clinical significance of depression in Arab CV patients. It might contribute to development of culturally appropriate and effective mental health care services. Multiple databases were searched and 60 articles were assessed, including studies that investigated depression in Arab CV patient populations, physiological mechanisms of depression-CVD comorbidity, and intervention strategies that affect CV risk in depressed Arab patients. We discuss the extent to which this issue has been explored in Arab populations living in Middle East regions and Arab populations living abroad. We recommend that more comprehensive and in-depth research studies be conducted with Arab cardiac patients to enable implementation of culturally appropriate and effective mental health care interventions.


Depression Depression and cardiovascular diseases Arab cardiac patients Arab patients’ mental health care Depression among cardiovascular patients in the Middle East 



Acute coronary artery syndrome


Acute myocardial infarction


Autonomic nervous system

apo A

Apolipoprotein A

apo B

Apolipoprotein B


Atrial septal defect


Beck Depression Inventory


Coronary artery bypass graft


Coronary artery disease


Centre for Epidemiological Studies Depression Scale


Clinical Global Impression Severity Scale


Clinical interview schedule


Cardiac rehabilitation


C-reactive protein


Cardiovascular disease


Depression Anxiety Stress Scale




Electroconvulsive therapy


Geriatric Depression Scale


Hospital Anxiety and Depression Scale


Hamilton Depression Rating Scale


High density lipoproteins


Hypothalamic pituitary adrenal


Health related quality of life


Heart rate variability


Hopkins Symptoms Checklist 25


Inspiratory muscle training


Low density lipoproteins

Lp a

Lipoprotein a


Left ventricular


Mental Health Inventory


Myocardial infarction


Minnesota Living with Heart Failure Questionnaire


Mean platelet volume


Nottingham Health Profile


Nitric oxide


Psychosocial Adjustment to Illness Scale—Self Report Version


Population attributable risk


Patient Health Questionnaire


P wave dispersion


QT dispersion


Medical Outcomes Study—36-item Short Form Survey


Selective serotonin reuptake inhibitor


aka TNO/AZL Adult Quality of Life




United Arab Emirates


Visual Analogue Scale


Vesicular monoamine transporter



This publication was made possible by a grant from Qatar National Research Fund under its National Priority Research Program (NPRP 5-106-3-025). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Qatar National Research Fund.


  1. 1.
    Baune BT, Stuart M, Gilmour A, Wersching H, Arolt V, Berger K. Moderators of the relationship between depression and cardiovascular disorders: a systematic review. Gen Hosp Psychiatry. 2012;34:478–92.PubMedGoogle Scholar
  2. 2.
    Liu SS, Ziegelstein RC. Depression in patients with heart disease: the case for more trials. Future Cardiol. 2010;6:547–56.PubMedCentralPubMedGoogle Scholar
  3. 3.
    Nemeroff CB, Goldschmidt-Clermont PJ. Heartache and heartbreak—the link between depression and cardiovascular disease. Nat Rev Cardiol. 2012;9:526–39.PubMedGoogle Scholar
  4. 4.
    Davidson KW, Korin MR. Depression and cardiovascular disease: selected findings, controversies, and clinical implications from 2009. Clevel Clin J Med. 2010;77(Suppl 3):S20–6.Google Scholar
  5. 5.
    Shiel WC. Depression symptoms. (2013).
  6. 6.
    Lichtman JH, Bigger JT Jr, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lespérance F, Mark DB, Sheps DS, Taylor CB, Froelicher ES. Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Psychiatric Association. Circulation. 2008;118:1768–75.PubMedGoogle Scholar
  7. 7.
    Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, Fauerbach JA, Bush DE, Ziegelstein RC. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med. 2006;21:30–8.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. 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.PubMedGoogle Scholar
  9. 9.
    Frasure-Smith N, Lespérance F. Depression and cardiac risk: present status and future directions. Postgrad Med J. 2010;86:193–6.PubMedGoogle Scholar
  10. 10.
    Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, Newman MF. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med. 2004;66:305–15.PubMedGoogle Scholar
  11. 11.
    Stewart JC, Janicki DL, Muldoon MF, Sutton-Tyrrell K, Kamarck TW. Negative emotions and 3-year progression of subclinical atherosclerosis. Arch Gen Psychiatry. 2007;64:225–33.PubMedGoogle Scholar
  12. 12.
    Wellenius GA, Mukamal KJ, Kulshreshtha A, Asonganyi S, Mittleman MA. Depressive symptoms and the risk of atherosclerotic progression among patients with coronary artery bypass grafts. Circulation. 2008;117:2313–9.PubMedCentralPubMedGoogle Scholar
  13. 13.
    Matthews KA, Chang YF, Sutton-Tyrrell K, Edmundowicz D, Bromberger JT. Recurrent major depression predicts progression of coronary calcification in healthy women: study of women’s health across the nation. Psychosom Med. 2010;72:742–7.PubMedCentralPubMedGoogle Scholar
  14. 14.
    Frasure-Smith N, Lespérance F, Irwin MR, Sauvé C, Lespérance J, Théroux P. Depression, C-reactive protein and two-year major adverse cardiac events in men after acute coronary syndromes. Biol Psychiatry. 2007;62:302–8.PubMedGoogle Scholar
  15. 15.
    Raedler TJ. Inflammatory mechanisms in major depressive disorder. Curr Opin Psychiatry. 2011;24:519–25.PubMedGoogle Scholar
  16. 16.
    Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Clevel Clin J Med. 2009;76(Suppl 2):S13–7.Google Scholar
  17. 17.
    Jokinen J, Nordström P. HPA axis hyperactivity and attempted suicide in young adult mood disorder inpatients. J Affect Disord. 2009;116:117–20.PubMedGoogle Scholar
  18. 18.
    Jokinen J, Nordström P. HPA axis hyperactivity and cardiovascular mortality in mood disorder inpatients. J Affect Disord. 2009;116:88–92.PubMedGoogle Scholar
  19. 19.
    Markovitz JH, Shuster JL, Chitwood WS, May RS, Tolbert LC. Platelet activation in depression and effects of sertraline treatment: an open-label study. Am J Psychiatry. 2000;157:1006–8.PubMedGoogle Scholar
  20. 20.
    Serebruany VL, Glassman AH, Malinin AI, Sane DC, Finkel MS, Krishnan RR, Atar D, Lekht V, O’Connor CM. Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials. Blood Coagul Fibrinolysis. 2003;14:563–7.PubMedGoogle Scholar
  21. 21.
    Gehi A, Musselman D, Otte C, Bruce Royster E, Ali S, Whooley MA. Depression and platelet activation in outpatients with stable coronary heart disease: findings from the Heart and Soul Study. Psychiatry Res. 2010;175:200–4.PubMedGoogle Scholar
  22. 22.
    Kamphuis MH, Geerlings MI, Tijhuis MA, Giampaoli S, Nissinen A, Grobbee DE, Kromhout D. Physical inactivity, depression, and risk of cardiovascular mortality. Med Sci Sports Exerc. 2007;39:1693–9.PubMedGoogle Scholar
  23. 23.
    Gehi A, Haas D, Pipkin S, Whooley MA. Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Arch Intern Med. 2005;165:2508–13.PubMedCentralPubMedGoogle Scholar
  24. 24.
    Rieckmann N, Kronish IM, Haas D, Gerin W, Chaplin WF, Burg MM, Vorchheimer D, Davidson KW. Persistent depressive symptoms lower aspirin adherence after acute coronary syndromes. Am Heart J. 2006;152:922–7.PubMedGoogle Scholar
  25. 25.
    Laje RP, Berman JA, Glassman AH. Depression and nicotine: preclinical and clinical evidence for common mechanisms. Curr Psychiatry Rep. 2001;3:470–4.PubMedGoogle Scholar
  26. 26.
    Paperwalla KN, Levin TT, Weiner J, Saravay SM. Smoking and depression. Med Clin N Am. 2004;88:1483–94.PubMedGoogle Scholar
  27. 27.
    Glazer KM, Emery CF, Frid DJ, Banyasz RE. Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. J Cardiopulm Rehabil. 2002;22:40–6.PubMedGoogle Scholar
  28. 28.
    Middle East. Wikepedia, the free encyclopedia; 2013.Google Scholar
  29. 29.
    Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746–53.PubMedGoogle Scholar
  30. 30.
    Gehani AA, Al-Hinai AT, Zubaid M, Almahmeed W, Hasani MM, Yusufali AH, Hassan MO, Lewis BS, Islam S, Rangarajan S, Yusuf S. Association of risk factors with acute myocardial infarction in Middle Eastern countries: the INTERHEART Middle East study. Eur J Prev Cardiol. 2014;21:400–10.Google Scholar
  31. 31.
    Awad HH, Zubaid M, Alsheikh-Ali AA, Al Suwaidi J, Anderson FA Jr, Gore JM, Goldberg RJ. Comparison of characteristics, management practices, and outcomes of patients between the global registry and the gulf registry of acute coronary events. Am J Cardiol. 2011;108:1252–8.PubMedGoogle Scholar
  32. 32.
    Ormel J, Von Korff M, Burger H, Scott K, Demyttenaere K, Huang YQ, Posada-Villa J, Pierre Lepine J, Angermeyer MC, Levinson D, de Girolamo G, Kawakami N, Karam E, Medina-Mora ME, Gureje O, Williams D, Haro JM, Bromet EJ, Alonso J, Kessler R. Mental disorders among persons with heart disease—results from World Mental Health surveys. Gen Hosp Psychiatry. 2007;29:325–34.PubMedCentralPubMedGoogle Scholar
  33. 33.
    Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S. INTERHEART investigators. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364:953–62.PubMedGoogle Scholar
  34. 34.
    Ghuloum S, Bener A, Abou-Saleh MT. Prevalence of mental disorders in adult population attending primary health care setting in Qatari population. J Pak Med Assoc. 2011;61:216–21.PubMedGoogle Scholar
  35. 35.
    el-Rufaie OE, Absood GH. Depression in primary health care. Arab J Psychiatry. 1994;5:39–47.Google Scholar
  36. 36.
    el-Rufaie OE. A psychiatric clinic in a primary care setting: evaluating the experience. Saudi Med J. 1988;9:20–4.Google Scholar
  37. 37.
    Okasha A. Mental health in the Middle East: an Egyptian perspective. Clin Psychol Rev. 1999;19:917–33.PubMedGoogle Scholar
  38. 38.
    Iancu I, Horesh N, Lepkifker E, Drory Y. An epidemiological study of depressive symptomatology among Israeli adults: prevalence of depressive symptoms and demographic risk factors. Isr J Psychiatry Relat Sci. 2003;40:82–9.PubMedGoogle Scholar
  39. 39.
    Kaplan G, Glasser S, Murad H, Atamna A, Alpert G, Goldbourt U, Kalter-Leibovici O. Depression among Arabs and Jews in Israel: a population-based study. Soc Psychiatry Psychiatr Epidemiol. 2010;45:931–9.PubMedGoogle Scholar
  40. 40.
    Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet. 1997;349:1498–504.PubMedGoogle Scholar
  41. 41.
    Lopez AD, Murray CC. The global burden of disease, 1990–2020. Nat Med. 1998;4:1241–3.PubMedGoogle Scholar
  42. 42.
    Kronfol NM. Access and barriers to health care delivery in Arab countries: a review. East Mediterr Health J. 2012;18:1239–46.PubMedGoogle Scholar
  43. 43.
    Kronfol NM. Health services to groups with special needs in the Arab world: a review. East Mediterr Health J. 2012;18:1247–53.PubMedGoogle Scholar
  44. 44.
    Gearing RE, Mackenzie MJ, Brewer KB, Ibrahim RW, Olimat HS, Al-Makhamreh SS, Mian I, Al-Krenawi A. Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation. Int J Soc Psychiatry. 2013;59:671–81.Google Scholar
  45. 45.
    Ghuloum S, Bener A, Burgut FT. Epidemiological survey of knowledge, attitudes and health literacy concerning mental illness in a national community sample: a global burden. J Prim Care Community Health. 2010;1:111–8.PubMedGoogle Scholar
  46. 46.
    Bener A, Ghuloum S. Gender differences in the knowledge, attitude and practice towards mental health illness in a rapidly developing Arab society. Int J Soc Psychiatry. 2011;57:480–6.PubMedGoogle Scholar
  47. 47.
    Al-Krenawi A, Graham JR. Gender and biomedical/traditional mental health utilization among the Bedouin-Arabs of the Negev. Cult Med Psychiatry. 1999;23:219–43.PubMedGoogle Scholar
  48. 48.
    Saxena S, Thornicroft G, Knapp M, Whiteford H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet. 2007;370:878–89.PubMedGoogle Scholar
  49. 49.
    Gearing RE, Brewer KB, Schwalbe CS, Mackenzie MJ, Ibrahim RW. Stigma and adolescents with psychosis in the Middle East: implications for engaging in mental health treatment. J Nerv Ment Dis. 2013;201:68–71.PubMedGoogle Scholar
  50. 50.
    Al-Krenawi A. Family therapy with a multiparental/multispousal family. Fam Process. 1998;37:65–81.PubMedGoogle Scholar
  51. 51.
    Al-Krenawi A, Graham JR, Al-Bedah EA, Kadri HM, Sehwail MA. Cross-national comparison of Middle Eastern university students: help-seeking behaviors, attitudes toward helping professionals, and cultural beliefs about mental health problems. Community Ment Health J. 2009;45:26–36.PubMedGoogle Scholar
  52. 52.
    Hamdan A. Mental health needs of Arab women. Health Care Women Int. 2009;30:595–613.PubMedGoogle Scholar
  53. 53.
    Jaalouk D, Okasha A, Salamoun MM, Karam EG. Mental health research in the Arab world. Soc Psychiatry Psychiatr Epidemiol. 2012;47:1727–31.PubMedGoogle Scholar
  54. 54.
    Okasha A, Karam E, Okasha T. Mental health services in the Arab world. World Psychiatry. 2012;11:52–4.PubMedCentralPubMedGoogle Scholar
  55. 55.
    Lip GY, Barnett AH, Bradbury A, Cappuccio FP, Gill PS, Hughes E, Imray C, Jolly K, Patel K. Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management. J Hum Hypertens. 2007;21:183–211.PubMedGoogle Scholar
  56. 56.
    Jolly K, Gill P. Ethnicity and cardiovascular disease prevention: practical clinical considerations. Curr Opin Cardiol. 2008;23:465–70.PubMedGoogle Scholar
  57. 57.
    Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.PubMedGoogle Scholar
  58. 58.
    Strine TW, Mokdad AH, Balluz LS, Gonzalez O, Crider R, Berry JT, Kroenke K. Depression and anxiety in the United States: findings from the 2006 Behavioral Risk Factor Surveillance System. Psychiatr Serv. 2008;59:1383–90.PubMedGoogle Scholar
  59. 59.
    Kilzieh N, Rastam S, Maziak W, Ward KD. Comorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria. Int J Psychiatry Med. 2008;38:169–84.PubMedCentralPubMedGoogle Scholar
  60. 60.
    Cankurtaran M, Halil M, Yavuz BB, Dagli N, Cankurtaran ES, Ariogul S. Depression and concomitant diseases in a Turkish geriatric outpatient setting. Arch Gerontol Geriatr. 2005;40:307–15.PubMedGoogle Scholar
  61. 61.
    Mohamed EM, Abd-Elhamed MA. Depression among elderly attending geriatric clubs in Assiut City, Egypt. J Am Sci. 2011;7:386–91.Google Scholar
  62. 62.
    Bener A, Kamal A, Fares A, Sabuncuoglu O. The prospective study of anxiety, depression and stress on development of hypertension. Arab J Psychiatry. 2004;15:131–6.Google Scholar
  63. 63.
    Bener A, Kamal A, Al-Banna M, Al-Mulla A, Elbagi IA. Are symptoms of anxiety depression and stress risk factors for hypertension? Cardiology. 2006;2:45–51.Google Scholar
  64. 64.
    el-Rufaie OE, Bener A, Ali TA, Abuzeid MSO. Psychiatric morbidity among hypertensive men: a controlled study. Nord J Psychiatry. 1999;53:41–4.Google Scholar
  65. 65.
    Abdul-Mohsen MF. Frequency of depression among patients with acute coronary syndrome, eastern region, Saudi Arabia. J Fam Community Med. 2004;11:23–9.Google Scholar
  66. 66.
    Vural M, Acer M, Akbas B. The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyol Derg. 2008;8:43–7.PubMedGoogle Scholar
  67. 67.
    Hatmi ZN, Nasiri LF, Sadegianmehr Z, Mirkia S, Darbooy S. Association of myocardial infarction with stressful life events and psychiatric symptoms: a population-based survey. East Mediterr Health J. 2011;17:398–403.PubMedGoogle Scholar
  68. 68.
    Eken C, Oktay C, Bacanli A, Gulen B, Koparan C, Ugras SS, Cete Y. Anxiety and depressive disorders in patients presenting with chest pain to the emergency department: a comparison between cardiac and non-cardiac origin. J Emerg Med. 2010;39:144–50.PubMedGoogle Scholar
  69. 69.
    Myers V, Gerber Y, Benyamini Y, Goldbourt U, Drory Y. Post-myocardial infarction depression: increased hospital admissions and reduced adoption of secondary prevention measures—a longitudinal study. J Psychosom Res. 2012;72:5–10.PubMedGoogle Scholar
  70. 70.
    Vural M, Satiroglu O, Akbas B, Göksel I, Karabay O. Association between depression and anxiety symptoms and major atherosclerosis risk factors in patients with chest pain. Tohoku J Exp Med. 2007;212:169–75.PubMedGoogle Scholar
  71. 71.
    Vural M, Satiroglu O, Akbas B, Göksel I, Karabay O. Coronary artery disease in association with depression or anxiety among patients undergoing angiography to investigate chest pain. Tex Heart Inst J. 2009;36:17–23.PubMedCentralPubMedGoogle Scholar
  72. 72.
    Dogdu O, Yarlioglues M, Kaya MG, Ardic I, Akpek M, Senarslan O, Elcik D, Sahin O, Tulumen E, Calapkorur B, Kalay N. Relationship between psychosocial status, diabetes mellitus, and left ventricular systolic function in patients with stable multivessel coronary artery disease. Cardiol J. 2012;19:249–55.PubMedGoogle Scholar
  73. 73.
    Ghaemian A, Mohammadpour RA, Hosseini SH, Emadi SH. Depression in heart failure patients and the influence of age, gender and severity of depression on heart failure patients. J Teh Univ Heart Cent. 2007;1:31–4.Google Scholar
  74. 74.
    Hosseini SH, Yousefnejad K, Tabiban S, Nesarhoseyni V, Bagheri B, Kiasari AM, Ghaemian A, Ghadirnejad SN, Lolati HA, Amiri FN, Ashraf H, Mokhberi V. Effects of depression and anxiety symptoms on cardiac mortality following myocardial infarction: a 2-year follow-up. Int J Psychiatry Clin Pract. 2011;15:91–6.PubMedGoogle Scholar
  75. 75.
    Nemati MH, Astaneh B. The impact of coronary artery bypass graft surgery on depression and anxiety. J Cardiovasc Med (Hagerstown). 2011;12:401–4.Google Scholar
  76. 76.
    Drory Y, Kravetz S, Florian V. Psychosocial adjustment in patients after a first acute myocardial infarction: the contribution of salutogenic and pathogenic variables. Israel Study Group on First Acute Myocardial Infarction. Arch Phys Med Rehabil. 1999;80:811–8.PubMedGoogle Scholar
  77. 77.
    Drory Y, Kravetz S, Hirschberger G. Long-term mental health of men after a first acute myocardial infarction. Israeli Study Group on First Acute Myocardial Infarction. Arch Phys Med Rehabil. 2002;83:352–9.PubMedGoogle Scholar
  78. 78.
    Cohen M, Daniela M, Yalonetsky S, Gagin R, Lorber A. Psychological functioning and health-related quality of life (HRQoL) in older patients following percutaneous closure of the secundum atrial septal defect (ASD). Arch Gerontol Geriatr. 2010;50:e5–8.PubMedGoogle Scholar
  79. 79.
    Karapolat H, Eyigor S, Zoghi M, Nalbantgil S, Yagdi T, Durmaz B, Ozbaran M. Health related quality of life in patients awaiting heart transplantation. Tohoku J Exp Med. 2008;214:17–25.PubMedGoogle Scholar
  80. 80.
    Karapolat H, Eyigor S, Durmaz B, Yagdi T, Nalbantgil S, Karakula S. The relationship between depressive symptoms and anxiety and quality of life and functional capacity in heart transplant patients. Clin Res Cardiol. 2007;96:593–9.PubMedGoogle Scholar
  81. 81.
    Akyol Y, Durmus D, Dogan C, Bek Y, Canturk F. Quality of life and level of depressive symptoms in the geriatric population. Turk J Rheumatol (Aves Yayincilik Ltd STI). 2010;25:165–73.Google Scholar
  82. 82.
    Shah NM, Badr HE, Shah MA. The role of sociodemographic factors and chronic illness in functional disability of older Kuwaitis. J Appl Gerontol. 2011;30:607–28.Google Scholar
  83. 83.
    Ben-Noun LL. Coronary artery bypass grafting: long-term psychological and social outcomes. J Anxiety Disord. 1999;13:505–12.PubMedGoogle Scholar
  84. 84.
    El-Gatit AM, Haw M. Relationship between depression and non-adherence to anticoagulant therapy after valve replacement. East Mediterr Health J. 2003;9:12–9.PubMedGoogle Scholar
  85. 85.
    Gerber Y, Koren-Morag N, Myers V, Benyamini Y, Goldbourt U, Drory Y. Long-term predictors of smoking cessation in a cohort of myocardial infarction survivors: a longitudinal study. Israeli Study Group on First Acute Myocardial Infarction. Eur J Cardiovasc Prev Rehabil. 2011;18:533–41.PubMedGoogle Scholar
  86. 86.
    Statistical facts sheet—populations 2011 update. American Heart Association; 2011.Google Scholar
  87. 87.
    Linke SE, Rutledge T, Johnson BD, Vaccarino V, Bittner V, Cornell CE, Eteiba W, Sheps DS, Krantz DS, Parashar S, Bairey Merz CN. Depressive symptom dimensions and cardiovascular prognosis among women with suspected myocardial ischemia: a report from the National Heart, Lung, and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation. Arch Gen Psychiatry. 2009;66:499–507.PubMedCentralPubMedGoogle Scholar
  88. 88.
    Reeves WC, Strine TW, Pratt LA, Thompson W, Ahluwalia I, Dhingra SS, McKnight-Eily LR, Harrison L, D’Angelo DV, Williams L, Morrow B, Gould D, Safran MA. Centers for Disease Control and Prevention (CDC). Mental illness surveillance among adults in the United States. MMWR Surveill Summ. 2011;60(Suppl 3):1–29.PubMedGoogle Scholar
  89. 89.
    Sanner JE, Frazier L, Udtha M. Self-reported depressive symptoms in women hospitalized for acute coronary syndrome. J Psychiatr Ment Health Nurs. 2013;20:913–20.Google Scholar
  90. 90.
    Lutwak N, Dill C. Depression and cardiovascular disease in women. J Womens Health (Larchmt). 2012;21:702.Google Scholar
  91. 91.
    Naqvi TZ, Naqvi SSA, Bairey Merz CN. Gender differences in the link between depression and cardiovascular disease. Psychosom Med. 2005;67(Suppl 1):S15–8.PubMedGoogle Scholar
  92. 92.
    Rutledge T, Linke SE, Johnson BD, Bittner V, Krantz DS, Cornell CE, Vaccarino V, Pepine CJ, Handberg EM, Eteiba W, Shaw LJ, Parashar S, Eastwood JA, Vido DA, Bairey Merz CN. Relationships between cardiovascular disease risk factors and depressive symptoms as predictors of cardiovascular disease events in women. J Womens Health (Larchmt). 2012;21:133–9.Google Scholar
  93. 93.
    Doering LV, Eastwood JA. A literature review of depression, anxiety, and cardiovascular disease in women. J Obstet Gynecol Neonatal Nurs. 2011;40:348–61.PubMedGoogle Scholar
  94. 94.
    Drory Y, Kravetz S, Hirschberger G. Long-term mental health of women after a first acute myocardial infarction. Israeli Study Group on First Acute Myocardial Infarction. Arch Phys Med Rehabil. 2003;84:1492–8.PubMedGoogle Scholar
  95. 95.
    Gidron Y, Levy A, Cwikel J. Psychosocial and reported inflammatory disease correlates of self-reported heart disease in women from South of Israel. Women Health. 2006;44:25–40.PubMedGoogle Scholar
  96. 96.
    Kilzieh N, Rastam S, Ward KD, Maziak W. Gender, depression and physical impairment: an epidemiologic perspective from Aleppo, Syria. Soc Psychiatry Psychiatr Epidemiol. 2010;45:595–602.PubMedCentralPubMedGoogle Scholar
  97. 97.
    Tadmouri GO. The Arab world. In: Tadmouri GO, Al Ali TM, Al Khaja N, editors. Genetic disorders in Arab World, vol. 1, 2004.Google Scholar
  98. 98.
    Demographics, Arab American Institute; 2013.Google Scholar
  99. 99.
    Jamil H, Dallo F, Fakhouri M, Templin T, Khoury R, Fakhouri H. The prevalence of self-reported chronic conditions among Arab, Chaldean, and African Americans in southeast Michigan. Ethn Dis. 2009;19:293–300.PubMedGoogle Scholar
  100. 100.
    Jamil H, Grzybowski M, Hakim-Larson J, Fakhouri M, Sahutoglu J, Khoury R, Fakhouri H. Factors associated with self-reported depression in Arab, Chaldean, and African Americans. Ethn Dis. 2008;18:464–70.PubMedGoogle Scholar
  101. 101.
    Jamil H, Hakim-Larson J, Farrag M, Kafaji T, Duqum I, Jamil LH. A retrospective study of Arab American mental health clients: trauma and the Iraqi refugees. Am J Orthopsychiatry. 2002;72:355–61.PubMedGoogle Scholar
  102. 102.
    Jamil H, Hakim-Larson J, Farrag M, Kafaji T, Jamil LH, Hammad A. Medical complaints among Iraqi American refugees with mental disorders. J Immigr Health. 2005;7:145–52.PubMedGoogle Scholar
  103. 103.
    Aboumediene S, Farrag M, Dakroub M. Depression and medical health complaints in a group of Arab-American women. Ethn Dis. 2005;15:S1-106-7.PubMedGoogle Scholar
  104. 104.
    Shara NM, Carter EA, Abu-Bader S, Deshields A, Fokar A, Howard BV. Cardiovascular disease risk factors in Arab Americans living in Metropolitan Washington DC. Curr Cardiovasc Risk Rep. 2010;4:181–5.Google Scholar
  105. 105.
    Gholizadeh L, Salamonson Y, Worrall-Carter L, DiGiacomo M, Davidson PM. Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia. J Women’s Health (Larchmt). 2009;18:1385–93.Google Scholar
  106. 106.
    Shara NM, Carter EA, Abu-Bader S, Deshields A, Fokar A, Howard BV. Cardiovascular disease risk factors in Arab Americans living in Metropolitan Washington DC. Curr Cardiovasc Risk Rep. 2010;4:181–5.Google Scholar
  107. 107.
    Reimann JO, Rodriguez-Reimann DI, Ghulan M, Beylouni MF. Health issues in the Arab American community. Project Salaam: assessing mental health needs among San Diego’s greater Middle Eastern and East African communities. Ethn Dis. 2007;17:S3-39–41.Google Scholar
  108. 108.
    Dallo FJ, Borrell LN. Self-reported diabetes and hypertension among Arab Americans in the United States. Ethn Dis. 2006;16:699–705.PubMedGoogle Scholar
  109. 109.
    Harb WA. Health issues in the Arab American community. Managing cardiovascular risk barriers to optimal health outcomes in the Arab American patient. Ethn Dis. 2007;17:S3-28–30.Google Scholar
  110. 110.
    Kulwicki AD, Miller J, Schim SM. Collaborative partnership for culture care: enhancing health services for the Arab community. J Transcult Nurs. 2000;11:31–9.PubMedGoogle Scholar
  111. 111.
    Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol. 2013;2013:695925.PubMedCentralPubMedGoogle Scholar
  112. 112.
    Carney RM, Saunders RD, Freedland KE, Stein P, Rich MW, Jaffe AS. Association of depression with reduced heart rate variability in coronary artery disease. Am J Cardiol. 1995;76:562–4.PubMedGoogle Scholar
  113. 113.
    Yilmaz R, Demirbag R. P-wave dispersion in patients with stable coronary artery disease and its relationship with severity of the disease. J Electrocardiol. 2005;38:279–84.PubMedGoogle Scholar
  114. 114.
    Okin PM, Devereux RB, Howard BV, Fabsitz RR, Lee ET, Welty TK. Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: the Strong Heart Study. Circulation. 2000;101:61–6.PubMedGoogle Scholar
  115. 115.
    Yavuzkir M, Atmaca M, Dagli N, Balin M, Karaca I, Mermi O, Tezcan E, Aslan IN. P-wave dispersion in panic disorder. Psychosom Med. 2007;69:344–7.PubMedGoogle Scholar
  116. 116.
    Kocer E, Alcelik A, Kocer A, Onder E, Aaoglu A. Increased P wave duration in patients with depression or anxiety disorder. Neural Regen Res. 2010;5:545–9.Google Scholar
  117. 117.
    Arslan A, Uzun M. Does the lower nitric oxide level cause cardiovascular changes in major depressed women? Eur Rev Med Pharmacol Sci. 2008;12:309–13.PubMedGoogle Scholar
  118. 118.
    Nahshoni E, Aizenberg D, Strasberg B, Dorfman P, Sigler M, Imbar S, Weizman A. QT dispersion in the surface electrocardiogram in elderly patients with major depression. J Affect Disord. 2000;60:197–200.PubMedGoogle Scholar
  119. 119.
    Xhyheri B, Manfrini O, Mazzolini M, Pizzi C, Bugiardini R. Heart rate variability today. Prog Cardiovasc Dis. 2012;55:321–31.PubMedGoogle Scholar
  120. 120.
    Nahshoni E, Aravot D, Aizenberg D, Sigler M, Zalsman G, Strasberg B, Imbar S, Adler E, Weizman A. Heart rate variability in patients with major depression. Psychosomatics. 2004;45:129–34.PubMedGoogle Scholar
  121. 121.
    Nahshoni E, Aizenberg D, Sigler M, Zalsman G, Strasberg B, Imbar S, Weizman A. Heart rate variability in elderly patients before and after electroconvulsive therapy. Am J Geriatr Psychiatry. 2001;9:255–60.PubMedGoogle Scholar
  122. 122.
    Nahshoni E, Aizenberg D, Sigler M, Strasberg B, Zalsman G, Imbar S, Adler E, Weizman A. Heart rate variability increases in elderly depressed patients who respond to electroconvulsive therapy. J Psychosom Res. 2004;56:89–94.PubMedGoogle Scholar
  123. 123.
    Triggle CR, Samuel SM, Ravishankar S, Marei I, Arunachalam G, Ding H. The endothelium: influencing vascular smooth muscle in many ways. Can J Physiol Pharmacol. 2012;90:713–38.PubMedGoogle Scholar
  124. 124.
    Marti CN, Gheorghiade M, Kalogeropoulos AP, Georgiopoulou VV, Quyyumi AA, Butler J. Endothelial dysfunction, arterial stiffness, and heart failure. J Am Coll Cardiol. 2012;60:1455–69.PubMedGoogle Scholar
  125. 125.
    Evora PR, Evora PM, Celotto AC, Rodrigues AJ, Joviliano EE. Cardiovascular therapeutics targets on the NO-sGC-cGMP signaling pathway: a critical overview. Curr Drug Targets. 2012;13:1207–14.PubMedGoogle Scholar
  126. 126.
    Yapislar HH, Aydogan SS, Ozüm ÜÜ. Biological understanding of the cardiovascular risk associated with major depression and panic disorder is important. Int J Psychiatry Clin Pract. 2012;16:27–32.PubMedGoogle Scholar
  127. 127.
    Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995;274:1049–57.PubMedGoogle Scholar
  128. 128.
    Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002;288:2015–22.Google Scholar
  129. 129.
    McNulty H, Pentieva K, Hoey L, Ward M. Homocysteine, B-vitamins and CVD. Proc Nutr Soc. 2008;67:232–7.PubMedGoogle Scholar
  130. 130.
    Ataoglu A, Canan F. Mean platelet volume in patients with major depression: effect of escitalopram treatment. J Clin Psychopharmacol. 2009;29:368–71.PubMedGoogle Scholar
  131. 131.
    Bismuth-Evenzal Y, Gonopolsky Y, Gurwitz D, Iancu I, Weizman A, Rehavi M. Decreased serotonin content and reduced agonist-induced aggregation in platelets of patients chronically medicated with SSRI drugs. J Affect Disord. 2012;136:99–103.PubMedGoogle Scholar
  132. 132.
    Zucker M, Aviv A, Shelef A, Weizman A, Rehavi M. Elevated platelet vesicular monoamine transporter density in untreated patients diagnosed with major depression. Psychiatry Res. 2002;112:251–6.PubMedGoogle Scholar
  133. 133.
    Dubé JB, Boffa MB, Hegele RA, Koschinsky ML. Lipoprotein(a): more interesting than ever after 50 years. Curr Opin Lipidol. 2012;23:133–40.PubMedGoogle Scholar
  134. 134.
    Mangalmurti SS, Davidson MH. The incremental value of lipids and inflammatory biomarkers in determining residual cardiovascular risk. Curr Atheroscler Rep. 2011;13:373–80.PubMedGoogle Scholar
  135. 135.
    Hamidifard S, Fakhari A, Mahboob S, Gargari BP. Plasma levels of lipoprotein (a) in patients with major depressive disorders. Psychiatry Res. 2009;169:253–6.PubMedGoogle Scholar
  136. 136.
    Sadeghi M, Roohafza H, Afshar H, Rajabi F, Ramzani M, Shemirani H, Sarafzadeghan N. Relationship between depression and apolipoproteins A and B: a case–control study. Clinics (Sao Paulo). 2011;66:113–7.Google Scholar
  137. 137.
    Toker S, Shirom A, Melamed S. Depression and the metabolic syndrome: gender-dependent associations. Depress Anxiety. 2008;25:661–9.PubMedGoogle Scholar
  138. 138.
    Toker S, Shirom A, Shapira I, Berliner S, Melamed S. The association between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women. J Occup Health Psychol. 2005;10:344–62.PubMedGoogle Scholar
  139. 139.
    Oldridge N. Exercise-based cardiac rehabilitation in patients with coronary heart disease: meta-analysis outcomes revisited. Future Cardiol. 2012;8:729–51.PubMedGoogle Scholar
  140. 140.
    van der Meer S, Zwerink M, van Brussel M, van der Valk P, Wajon E, van der Palen J. Effect of outpatient exercise training programmes in patients with chronic heart failure: a systematic review. Eur J Prev Cardiol. 2012;19:795–803.PubMedGoogle Scholar
  141. 141.
    Eshah NF, Bond AE. Cardiac rehabilitation programme for coronary heart disease patients: an integrative literature review. Int J Nurs Pract. 2009;15:131–9.PubMedGoogle Scholar
  142. 142.
    Karapolat HU, Kurtais Y, Tur BS, Demirsoy N, Özyemisci Taskiran Ö, Sarp Ü, Hafiz M, Külcu DG, Sarikaya S, Soyupek F, Sütbeyaz ST, Delialioglu SÜ, Alemdaroglu E, Ordu Gökkaya NK, Dogan A, Köseoglu F, Eksioglu E, Duyur Çakit B, Dülgeroglu Erdogdu D, Tuncay F, Figen Ayhan F, Güzel R. What do patients really know about cardiopulmonary rehabilitation: a cross-sectional survey study. Eur J Phys Rehabil Med. 2012;48:223–30.PubMedGoogle Scholar
  143. 143.
    Ulubay G, Ulasli SS, Sezgin A, Haberal M. Assessing exercise performance after heart transplantation. Clin Transplant. 2007;21:398–404.PubMedGoogle Scholar
  144. 144.
    Sharif F, Shoul A, Janati M, Kojuri J, Zare N. The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran. BMC Cardiovasc Disord. 2012;12:40.PubMedCentralPubMedGoogle Scholar
  145. 145.
    Kulcu DG, Kurtais Y, Tur BS, Gülec S, Seckin B. The effect of cardiac rehabilitation on quality of life, anxiety and depression in patients with congestive heart failure. A randomized controlled trial, short-term results. Eura Medicophys. 2007;43:489–97.PubMedGoogle Scholar
  146. 146.
    Bosnak-Guclu M, Arikan H, Savci S, Inal-Ince D, Tulumen E, Aytemir K, Tokgözoglu L. Effects of inspiratory muscle training in patients with heart failure. Respir Med. 2011;105:1671–81.PubMedGoogle Scholar
  147. 147.
    Savci S, Degirmenci B, Saglam M, Arikan H, Inal-Ince D, Turan HN, Demircin M. Short-term effects of inspiratory muscle training in coronary artery bypass graft surgery: a randomized controlled trial. Scand Cardiovasc J. 2011;45:286–93.PubMedGoogle Scholar
  148. 148.
    Mutwalli HA, Fallows SJ, Arnous AA, Zamzami MS. Randomized controlled evaluation shows the effectiveness of a home-based cardiac rehabilitation program. Saudi Med J. 2012;33:152–9.PubMedGoogle Scholar
  149. 149.
    Karapolat H, Demir E, Bozkaya YT, Eyigör S, Nalbantgil S, Durmaz B, Zoghi M. Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters. Clin Res Cardiol. 2009;98:635–42.PubMedGoogle Scholar
  150. 150.
    Karapolat H, Eyigör S, Zoghi M, Yagdi T, Nalbangil S, Durmaz B. Comparison of hospital-supervised exercise versus home-based exercise in patients after orthotopic heart transplantation: effects on functional capacity, quality of life, and psychological symptoms. Transplant Proc. 2007;39:1586–8.PubMedGoogle Scholar
  151. 151.
    Delisle VC, Arthurs E, Abbey SE, Grace SL, Stewart DE, Steele RJ, Ziegelstein RC, Thombs BD. Symptom reporting on the Beck Depression Inventory among post-myocardial infarction patients: in-hospital versus follow-up assessments. J Psychosom Res. 2012;73:356–61.PubMedGoogle Scholar
  152. 152.
    Delisle VC, Abbey SE, Beck AT, Dobson KS, Dozois DJ, Grace SL, Stewart DE, Ziegelstein RC, Thombs BD. The influence of somatic symptoms on Beck Depression Inventory scores in hospitalized postmyocardial infarction patients. Can J Psychiatry. 2012;57:752–8.PubMedGoogle Scholar
  153. 153.
    Feinstein RE, Blumenfield M, Orlowski B, Frishman WH, Ovanessian S. A national survey of cardiovascular physicians’ beliefs and clinical care practices when diagnosing and treating depression in patients with cardiovascular disease. Cardiol Rev. 2006;14:164–9.PubMedGoogle Scholar
  154. 154.
    Thombs BD, Roseman M, Coyne JC, de Jonge P, Delisle VC, Arthurs E, Levis B, Ziegelstein RC. Does evidence support the American Heart Association’s recommendation to screen patients for depression in cardiovascular care? An updated systematic review. PLoS ONE. 2013;8:e52654.PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Tam Truong Donnelly
    • 1
    • 3
    Email author
  • Jassim Mohd Al Suwaidi
    • 2
  • Awad Al-Qahtani
    • 2
  • Nidal Asaad
    • 2
  • Najlaa Abdul Qader
    • 2
  • Rajvir Singh
    • 2
  • Tak Shing Fung
    • 3
  • Irem Mueed
    • 1
  • Shima Sharara
    • 1
  • Noha El Banna
    • 1
  • Sarah Omar
    • 1
  1. 1.University of Calgary-QatarDohaQatar
  2. 2.Hamad Medical CorporationDohaQatar
  3. 3.University of CalgaryCalgaryCanada

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