The relationship between depression and cardiovascular disorders.

Expanding scientific evidence supports a long-recognized link between cardiovascular disease and depression. As an independent risk factor, depression increases patient vulnerability to both cardiac events and mortality. Several important pathophysiologic mechanisms have been proposed, including hypothalamic-pituitary axis hyperactivity, autonomic nervous system dysfunction, and increased platelet reactivity, among others. The recently completed Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) inaugurates a series of studies intended to address the impact of antidepressant therapy on cardiovascular risk.