Could loss of pleasure in life portend cardiovascular disease? Possibly.
The vegetative symptoms of depression have been linked with thickening of the
Remember all the hype about the type-A personality a few years ago? This is
a person bristling with aggression and hostility. And certainly hostility and
anger have been linked with an increased risk of having a heart attack.
However, neither hostility nor anger seems to pave the way for the very
early stages of cardiovascular disease, a study published in the February
Archives of General Psychiatry suggested.
The researchers found no link between hostility or anger and thickening of
the carotid arteries in subjects who were followed over a three-year period.
The investigators did find, however, an association between the vegetative
symptoms of depression and such thickening over the same time span.
The lead investigator was Jesse Stewart, Ph.D., an assistant professor of
psychology at Indiana University-Purdue University, Indianapolis. He conducted
the inquiry while he was a postdoctoral fellow at the University of
Although depression and anxiety, as well as hostility or anger, have been
associated in the past with an increased risk of cardiovascular disease,
Stewart and his colleagues wanted to evaluate the relative contributions of
these four negative emotions to the early disease process.
The scientists were not able to link hostility, anger, or anxiety to
thickening of the carotid arteries, but they did find a significant
association, and a dose-response relationship, between depression and the
latter. In other words, the more depressed subjects were, the thicker their
carotid arteries became.
The investigators then looked to see whether particular depressive symptoms
could be coupled with thickening of the carotid arteries. Regarding the
cognitive symptoms of depression (sadness, pessimism, and indecisiveness), the
answer was no, but regarding the vegetative symptoms of depression (loss of
appetite and pleasure in life, fatigue, and sleep disturbances), the answer
“Our findings suggest that the somatic-vegetative features of
depression, but perhaps not anxiety, hostility, and anger, may play an
important role in the earlier stages of the development of coronary artery
disease,” Stewart and his group concluded in their study report.
Stewart told Psychiatric News that the absence of a link between
the negative emotions they evaluated and early thickening of the carotid
arteries was unexpected. And, he said, “It was also somewhat surprising
that only the vegetative symptoms of depression were predictive of greater
thickening of the carotid arteries over time.”
He pointed out, however, that hostility, anger, anxiety, and the cognitive
symptoms of depression may still play a role in the later development of
coronary artery disease. He also conjectured that while the means by which
negative emotions might contribute to coronary artery disease are not known,
inflammation may mediate the process.
In fact, he reported, “I am currently examining the relationships
between multiple negative emotions and inflammatory markers relevant to
cardiovascular disease such as the proinflammatory cytokine interleukin-6 and
the acute phase reactant C-reactive protein.”
The study was funded by the National Institutes of Health and the
Pittsburgh Mind-Body Center.
An abstract of “Negative Emotions and Three-Year Progression
of Subclinical Atherosclerosis” is posted at<http://archpsyc.ama-assn.org/cgi/content/abstract/64/2/225>.▪