Vol 9, No 1- Neuropsychiatry and Cardiovascular Disease
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large body of evidence has emerged to suggest an extensive comorbidity between depression and car- diovascular disease (CVD).Cross-sectional and prospec- tive analyses have shown that depression may increase mortality and morbidity in patients with heart failure, regardless of its etiology,and independently of tradi- tional cardiovascular factors.1Although this may be the result of psychological factors such as contemplation of one’s mortality and changes in lifestyle and social rela- tionships,there is now compelling evidence that a recip- rocal relationship between both disorders exists.The presence of cardiovascular disease can influence mood states,2and some of the factors associated with depres- sion,especially the multiple alterations associated with B a s i c  r e s e a r c h A Copyright © 2007 LLS SAS. All rights reserved www.dialogues-cns.org Common genetic factors for depression and cardiovascular disease Brigitta Bondy,MD Keywords:depression; cardiovascular disease; genetic polymorphism; seroto- nin; inflammation; angiotensin-converting enzyme Author affiliations:Psychiatric Hospital, University of Munich, Germany Address for correspondence:Prof Dr Brigitta Bondy, MD, Psychiatric Hospital, University of Munich, Nussbaumstrasse 7, D-80336 Munich, Germany (e-mail: Brigitta.Bondy@psy.med.uni-muenchen.de) There is increasing knowledge regarding the considerable comorbidity between depression and cardiovascular dis- ease, which are two of the most common disorders in developed countries. The associated vulnerability is not unidi- rectional, as the presence of cardiovascular disease can also influence mood states. Although this may be the result of psychological factors, common biological mechanisms, including genetic ones, are thought to be responsible for this interaction; we can thus question whether variations in genes could be predisposing factors. Regarding the multiple interactions in the mechanisms between depression and cardiovascular system disorders, eg, dysfunctions in the hypo- thalamic-pituitary-adrenocortical and sympathoadrenal axis and the response to stress, the importance of the sero- tonergic and immune systems, or the impact on the renin-angiotensin system, several candidate genes are being inves- tigated. However, despite the interest in unraveling the potential susceptibility genes for both disorders, most available studies have so far dealt with the impact of polymorphisms in relation to either depression or cardiovascular disease. A few recent studies have now examined the effects of gene-gene or gene-environment interactions, and are inves- tigating the impact of “depression-related” variants on cardiac response to stress. The first promising results were obtained with the serotonin transporter, and it may be hypothesized that this polymorphism interacts via the impact of the S allele on depression and via the effect of the L allele on platelet activation. However, the role played by var- ious other candidate genes remains to be determined, especially regarding the question as to whether they are indica- tive of common pathophysiological mechanisms, or for identifying a subgroup of patients with somatic disorders that are more closely related to psychiatric symptoms. © 2007, LLS SAS Dialogues Clin Neurosci. 2007;9:19-28.