Men who are depressed have higher levels of inflammatory markers associated with coronary heart disease than men who are not, according to a study reported in Circulation: Journal of the American Heart Association.
Some observational studies have linked depression with heart disease, which includes angina, non-fatal and fatal heart attacks, but the mechanism underlying the association is unknown.
Lead author Jean P. Empana, M.D., M.P.H., D.H., in the epidemiology department at Paul Brousse Hospital in Villejuif, France, said, “This is the first study investigating the respective contributions to coronary heart disease (CHD) of depression and inflammatory markers. Previous reports investigating the association between depression and individual inflammatory markers have produced conflicting results. In this study, we investigated a wide range of inflammatory markers.”
Researchers used data from the PRIME Study, a prospective study evaluating coronary heart disease factors in healthy middle-aged men in Ireland and France. They reviewed baseline blood samples of 304 men who developed heart disease within five years and 585 men who did not (controls). The men were healthy at baseline and were an average age of 55. Researchers noted levels of four inflammatory markers in their blood: C-reactive protein (CRP); fibrinogen; interleukin-6 (IL6); and adhesion cellular molecule -1 (ICAM-1).
The participants also answered questions evaluating negative perceptions of life, including statements such as, “I feel helpless.” The presence of depressive mood was defined as a depression score in the fourth quartile or higher at the baseline.
As expected, the average level of major cardiovascular risk factors and inflammatory markers were significantly higher in the men who developed heart disease than the controls. In addition, depressive mood was present in 28.3 percent of the cases versus 19.7 percent in the controls. Researchers noted a low but statistically significant correlation between depression score and IL6, CRP and ICAM-1, but not fibrinogen.