Depression аnd Cardiovascular Diseases: Cause, Consequence оr Comorbidity

Introduction. According to the World Health Organization (WHO) Report currently more than 350 million people in the world suffer from clinically significant anxiety and depressive disorders and this number is expected to grow. Depression is the leading cause of disability worldwide. The special attention should be given to the category of patients with the cardiovascular diseases, because the existence of depression greatly deteriorates the disease course. Aim. To analyze the literature sources and to propose own thoughts on the topic of the depression and cardiovascular diseases, their causes, consequence or comorbidity. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of research of actual scientific researches on the topic of the depression and cardiovascular diseases, their causes, consequence or comorbidity was made. Results and discussion. The combination of depression and cardiovascular diseases is a well-known clinical fact, supported by the results of many clinical studies. Since the 90's more than 100 descriptive studies in this field assessing the relationship of depression with cardiovascular morbidity and mortality have been performed. Women are 1.7 times more likely to experience a significant depression than men. The majority of clinical studies of depression in patients with heart failure do not provide a separate data for men and women. One study analyzed the prevalence of depression in patients with heart failure only in out-of-hospital settings. The symptoms of depression were observed in 64 % of the women and 44 % of the men. There are different pathological mechanisms of depression in cardiovascular diseases. The first is the psychological aspect associated with the development of life-threatening condition. The feeling of fear of death, anxiety about the future course of the disease, restrictions of physical activity, necessity of the invasive procedures usually cause anxiety andor depression in patients in the acute phase of the disease. For the early post-myocardial infarction patients' depression substrate more often is due to the impossibility of returning to normal physically active life, reduced work capacity, social adjustment difficulties and the impact of myocardial infarction on sexual activity. At the same time, despite the psychological mechanisms of depression, the dysfunction of the heart muscle also attributes to the development of depression. Myocardial dysfunction is usually observed in cardiovascular diseases (coronary heart disease, arterial hypertension, cardiomyopathy, inflammatory heart diseases, valvular lesions). Conclusions. The depression in terms of cardiovascular diseases may act as a risk factor for their development, it can be a cause of the heart muscle dysfunction, as well as be caused by psychological problems in consequence of the disease.