According to a report in the February issue of Archives of General Psychiatry, one of the JAMA/Archives journals, depressive symptoms—especially physical signs, such as// fatigue and loss of appetite—may be associated with thickening arteries, which may reflect an early sign of coronary artery disease.

Considerable evidence suggests that depression, anger and other negative emotions are associated with the risk for coronary artery disease, which occurs when the vessels carrying blood to the heart become narrowed and thickened. However, most studies have assessed the risk for heart attack or sudden cardiac death, according to background information in the article. Because these events are later steps in the development of coronary artery disease, it is currently unclear whether depression, anxiety and other negative emotions play a role in early disease processes.

Jesse C. Stewart, Ph.D., then at the University of Pittsburgh School of Medicine and now at Indiana University–Purdue University Indianapolis, and colleagues studied 324 men and women who were an average of 60.6 years old.

At the beginning of the study, participants attended 11 visits in a five-month period, including a medical screening; testing for cardiovascular risk factors, including high blood pressure and high cholesterol; questionnaires to assess depression, anxiety, hostility and anger; and ultrasound tests to determine carotid artery intima-media thickness (IMT), a measure of the inner layers of the arteries that is related to early-stage coronary artery disease. Cardiovascular risk factors and IMT were assessed again after three years.

"Regression analyses indicated that higher depressive symptoms at baseline were associated with greater three-year change in carotid intima-media thickness, even after taking into account demographic factors, cardiovascular risk factors, medication use, medical conditions and other correlated negative emotions," the authors w
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