Persons with a depression or anxiety disorder are at an increased risk of developing cardiovascular disease. This relationship might be explained by a dysregulated autonomic nervous system in depression and anxiety. However, there are more factors involved, according to the PhD research performed by Mandy Hu. ‘The dysregulation of the autonomic nervous system, which could lead to cardiovascular disease risk in persons with poor mental health, is likely caused by antidepressant use and poor lifestyle.’ Hu will defend her thesis on March 11th at Amsterdam UMC.

During her PhD, Hu researched the autonomic nervous system as a possible underlying mechanism explaining the link between depressive and anxiety disorders and an increased risk of developing cardiovascular disease. She used three different study populations to investigate the relationship between poor mental health, autonomic dysregulation, and risk factors for cardiovascular disease.

Autonomic dysregulation

The autonomic nervous system is involved in the acute human stress response. This system also plays a major role in the regulation of cardiac activity. ‘Therefore,’ says Hu, ‘it’s plausible that depression and anxiety disorders might lead to autonomic dysregulation, and that autonomic dysregulation might lead to cardiovascular disease.’

Antidepressants and lifestyle

The research by Hu showed that poor mental health is likely not directly associated with autonomic dysregulation. Hu: ‘Depression and anxiety disorders seem to affect the autonomic nervous system, and consequently risk for cardiovascular disease, through the use of antidepressants and a poor lifestyle, such as smoking and low physical activity.

Alternative treatment

These results are important for public health, according to Hu. If poor mental health does not directly lead to autonomic dysregulation, this gives us an opportunity to intervene in this relationship. ‘Clinicians ought to be more careful in prescribing antidepressants. They could explore other treatment options, such as lifestyle changes, that render more positive effects on mental and physical health.’