Individuals with two short alleles at the serotonin transporter locus were more sensitive to stressful events than individuals with either one or two long alleles.56 Whether these same functional variants in a serotonin transporter can influence the risk of ischemic heart disease is at present unknown. Discussion There is strong evidence that both depression is associated with an increased risk of cardiovascular disease and cardiac death. In studies of large populations free of http://www.selleckchem.com/products/ABT-888.html medical disease, after controlling for all known

cardiovascular risk factors, it is those individuals with baseline depression that are more likely to develop cardiovascular disease. Inhibitors,research,lifescience,medical And, once they develop coronary artery disease, those who are observed to be depressed are at markedly increased risk of cardiac morbidity and mortality. Interestingly, this increased risk is not limited to patients with major depression. Patients with less than major depression, who have even modest increases in symptoms of depression, Inhibitors,research,lifescience,medical show a higher risk of recurrent infarction and cardiac death.14,15 The more severe the depression, the higher the risk. Depression also increases the risk of death and medical complications after coronary bypass surgery57 and in patients with

heart failure as well.18 Similar to the risk of cardiovascular Inhibitors,research,lifescience,medical disease, individuals with depression are also at higher risk of ischemic stroke, and after a stroke, patients who are depressed are at higher risk of medical complications and death.19,20,58 Inhibitors,research,lifescience,medical There is even evidence that antidepressant treatment reduces these medical risks.59 Most cases of major depression have their onset in the early adult years, and many become recurrent. This review has focused on these early-onset cases because they are the most common, and because examining such cases avoids confusing whether depression

precedes vascular disease or whether the early symptoms of vascular disease are responsible for the onset of depression. There is no question that depression can precede vascular Inhibitors,research,lifescience,medical disease by decades. To what degree this early-onset depression itself leads to vascular disease, and to what extent the association is the result of a common antecedent, remains Drug_discovery to be clarified. In addition to depression earlier in life, some cases of major depression clearly have their initial onset later in life, and a number of investigators have suggested that at least some of these cases are secondary to vascular changes in the brain. The earliest suggestions of such a relationship came from poststroke studies60 and more recently from imaging studies. Imaging studies have indicated that late-onset depression is more likely to show evidence of so-called white matter hyperintensities which are associated with hypertension and often thought to be evidence for arterial sclerotic changes in the brain.