孟德尔随机化
医学
共病
萧条(经济学)
疾病
随机化
随机对照试验
内科学
遗传学
基因
遗传变异
基因型
生物
宏观经济学
经济
标识
DOI:10.1161/jaha.120.019861
摘要
Depression and manifestations of cardiovascular disease (CVD), including coronary artery disease (CAD), myocardial infarction (MI), ischemic stroke, heart failure, and atrial fibrillation, are strongly comorbid.1 Given their high prevalence and the many years lost to disability caused, establishing the causality underlying their comorbidity is of huge public health value. This is not a simple mission. Apart from chance, which is nonnegligible with 2 highly prevalent conditions, several mechanisms could underlie the co-occurrence of depression and CVD, ranging from biological (inflammatory processes, dysfunction in the hypothalamic-pituitary-adrenal and autonomic nervous systems, and endothelial and platelet dysfunction) and behavioral mechanisms (physical inactivity, poor eating habits, smoking, and drinking) to a shared genetic vulnerability or chronic stress linked to socioeconomic status, both of which could independently affect the risk of developing depression and CVD. Of note, these mechanisms are not mutually exclusive, and the depression-CVD comorbidity is likely a composite of all of them. The exact mixture may differ across people and possibly be symptom specific.2.
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