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HPA axis hyperactivity and cardiovascular mortality in mood disorder inpatients.
J Affect Disord. 2009 Jul; 116(1-2):88-92.JA

Abstract

Depression is associated with an increased risk of cardiovascular disease (CVD), coronary heart disease (CHD) and cardiac death. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function is frequent in major depression and hypercortisolemia may be a mediating factor in these relationships. The aim of this study was to assess HPA axis function measured with the dexamethasone suppression test (DST) in relation to CVD and CHD mortality in a cohort of 382 inpatients with mood disorder admitted to the department of Psychiatry at the Karolinska University Hospital between 1980 and 2000. Death certificates ascertained that 75 patients had died of cardiovascular disease and 30 patients of CHD during the mean follow-up of 18 years. DST non-suppression and higher baseline serum cortisol predicted CVD death. In male inpatients with mood disorder, the DST non-suppressor status was significantly associated with CVD death but not with CHD death. In depressed female inpatients the DST non-suppression was not associated with cardiovascular mortality. Baseline serum cortisol and post-dexamethasone serum cortisol levels at 4:00 p.m. showed a trend to be higher in female CVD/CHD victims. Effect of aging on HPA axis functioning was shown in male CHD deaths. HPA axis dysregulation may be a mediating factor between depression and increased risk of cardiovascular death in male mood disorder inpatients indicating that HPA-axis hyperactivity is a long term risk factor for cardiovascular mortality.

Authors+Show Affiliations

Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden. jussi.jokinen@ki.seNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19054568

Citation

Jokinen, Jussi, and Peter Nordström. "HPA Axis Hyperactivity and Cardiovascular Mortality in Mood Disorder Inpatients." Journal of Affective Disorders, vol. 116, no. 1-2, 2009, pp. 88-92.
Jokinen J, Nordström P. HPA axis hyperactivity and cardiovascular mortality in mood disorder inpatients. J Affect Disord. 2009;116(1-2):88-92.
Jokinen, J., & Nordström, P. (2009). HPA axis hyperactivity and cardiovascular mortality in mood disorder inpatients. Journal of Affective Disorders, 116(1-2), 88-92. https://doi.org/10.1016/j.jad.2008.10.025
Jokinen J, Nordström P. HPA Axis Hyperactivity and Cardiovascular Mortality in Mood Disorder Inpatients. J Affect Disord. 2009;116(1-2):88-92. PubMed PMID: 19054568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HPA axis hyperactivity and cardiovascular mortality in mood disorder inpatients. AU - Jokinen,Jussi, AU - Nordström,Peter, Y1 - 2008/12/02/ PY - 2008/07/20/received PY - 2008/10/28/revised PY - 2008/10/28/accepted PY - 2008/12/5/pubmed PY - 2009/9/29/medline PY - 2008/12/5/entrez SP - 88 EP - 92 JF - Journal of affective disorders JO - J Affect Disord VL - 116 IS - 1-2 N2 - Depression is associated with an increased risk of cardiovascular disease (CVD), coronary heart disease (CHD) and cardiac death. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function is frequent in major depression and hypercortisolemia may be a mediating factor in these relationships. The aim of this study was to assess HPA axis function measured with the dexamethasone suppression test (DST) in relation to CVD and CHD mortality in a cohort of 382 inpatients with mood disorder admitted to the department of Psychiatry at the Karolinska University Hospital between 1980 and 2000. Death certificates ascertained that 75 patients had died of cardiovascular disease and 30 patients of CHD during the mean follow-up of 18 years. DST non-suppression and higher baseline serum cortisol predicted CVD death. In male inpatients with mood disorder, the DST non-suppressor status was significantly associated with CVD death but not with CHD death. In depressed female inpatients the DST non-suppression was not associated with cardiovascular mortality. Baseline serum cortisol and post-dexamethasone serum cortisol levels at 4:00 p.m. showed a trend to be higher in female CVD/CHD victims. Effect of aging on HPA axis functioning was shown in male CHD deaths. HPA axis dysregulation may be a mediating factor between depression and increased risk of cardiovascular death in male mood disorder inpatients indicating that HPA-axis hyperactivity is a long term risk factor for cardiovascular mortality. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19054568/HPA_axis_hyperactivity_and_cardiovascular_mortality_in_mood_disorder_inpatients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(08)00435-7 DB - PRIME DP - Unbound Medicine ER -