Abstract 13637: Depressive Symptoms, Antidepressants and Baroreflex Sensitivity. The Paris Prospective Study III
Background: While depressive symptoms have been consistently associated with an increased risk of cardiovascular disease, the underlying mechanisms are unclear.
Aims: To assess at the population level the relationship between depressive symptoms, antidepressants and baroreflex sensitivity (BRS), an indirect measure of the autonomic nervous system.
Methods: Within the ongoing French Paris Prospective Study III, 6433 men and women aged 50-75 underwent an echotracking of their right carotid arteries at baseline allowing measuring the gain function in the low frequency using cross-spectral analysis of distension rate versus heart rate. Subjects with a score above 7 on the 13-items QD2A depressive symptoms questionnaire were defined as depressed. Antidepressants treatments were retrieved at baseline on a self-report questionnaire and coded using the ATC classification. Association between depressive symptoms and below the median BRS was quantified by logistic regression after adjustment for age, sexe, blood pressure, heart rate, body mass index and diabetes on an a priori basis.
Results: The mean age was 59.6 years (SD 6.30) and 61% were males. There were 5.6% with depressive symptoms in whom 20.7% received antidepressants as compared to 3.8% in the non-depressed (p<0.01). There were 4.7% participants who received antidepressants, including 59% serotonin recapture inhibitors (SSRI) and 15% tricyclic antidepressants (TCA). In separate multivariate-adjusted analysis, antidepressants (OR: 1,35; 95% CI: 1,06- 1,71) but not depressive symptoms (OR:0,92 ;95% CI: 0,74- 1,15) were related to low BRS. Associations were consistent with SSRI (OR=1,25; 95% CI: 0,93; 1,70; p=0.14) and TCA (OR:1,64;95% CI:0,89-3,01; p=0.11). When entered in the same multivariable model, antidepressants (OR: 1,38; 95% CI: 1,08- 1,76) but not depressive symptoms were associated with low BRS and there was no interaction between treatment and depressive symptoms (p=0.39).
Conclusions: The present study suggests that antidepressant treatment but not depressive symptoms per se are associated with baroreflex sensitivity. Whether this reflects the pharmacological effect of antidepressants or the effect of more severe depressive symptoms should be further investigated.
- © 2013 by American Heart Association, Inc.