Treating depression in patients with cardiovascular disease.

Cardiovascular disease and depression are intimately related illnesses. Cardiovascular mortality is more common in persons with depression, and depression following a myocardial infarction is associated with significantly poorer cardiac outcome. Safe and effective simultaneous treatment of depression and cardiovascular illness can be difficult because of the interplay between these conditions. We examine the evidence for cardiovascular effects of depression, as well as the proposed mechanism for these effects. We also review the cardiovascular effects of antidepressant treatments and the mood-altering effects of common cardiovascular medications. Articles reviewed were derived from a Medline search of English-language articles published between 1970 and 1998 (search terms: cardiovascular disease, antidepressants, psychiatry, myocardial infarction, antihypertensive agents, depression).