Depression, Anxiety, and Arterial Stiffness

Background: Arterial stiffness gains attention as a potential mechanism underlying the frequently found association between depression or anxiety and cardiovascular disease. However, observations regarding stiffness and psychopathology were often based on small samples. The current study aimed to examine whether subjects with a diagnosis of depressive or anxiety disorder showed increased stiffness and to explore associations between various psychiatric characteristics and arterial stiffness. Methods: The sample included 449 cases with DSM-IV based lifetime diagnoses of depressive and/or anxiety disorder and 169 control subjects. Subjects were participating in the Netherlands Study of Depression and Anxiety and were aged 20 to 66 years. Characteristics included comorbidity, subtype of disorder, symptom severity and duration, age of onset, and use of antidepressant medication. Arterial stiffness was measured by calibrated radial tonometry (heart rate normalized central augmentation index [AIx75]; in percentage) and carotid M-mode ultrasound (distensibility coefficient). Results: After adjustment for covariates, AIx75 was increased in current (1-month) depression or anxiety (15.7% vs. 13.3% in control subjects, p = .01). Disorder characteristics associated with AIx75 were depression and anxiety comorbidity (15.3%, p = .02), higher depression severity (beta = .10, p < .001) and anxiety severity (beta = .10, p < .001), and longer symptom duration (beta = .07, p = .01). No significant associations were found between distensibility coefficient and psychopathology. Conclusions: Current depressive or anxiety disorders were associated with a higher central augmentation index, a manifestation of early wave reflection because of arterial stiffness. Exposure to depression and anxiety may therefore enhance the development and progression of atherosclerosis and other cardiovascular conditions.