Pathophysiological Relationships Between Heart Failure and Depression and Anxiety

Author:

Chapa Deborah W.1,Akintade Bimbola2,Son Heesook3,Woltz Patricia4,Hunt Dennis5,Friedmann Erika6,Hartung Mary Kay7,Thomas Sue Ann8

Affiliation:

1. Deborah Chapa is an assistant professor and coordinator of bachelor of nursing science to doctor of nursing practice at George Washington University, School of Nursing, Washington, DC. She is also an acute care nurse practitioner.

2. Bimbola Akintade is an assistant professor in the trauma, critical care, emergency department and clinical nurse specialist nurse practitioner program at the University of Maryland, School of Nursing, and an acute care nurse practitioner at Washington Hospital Center, Baltimore, Maryland.

3. Heesook Son is an assistant professor at Chung-Ang University School of Nursing, Seoul, South Korea.

4. Patricia Woltz is director of nursing research at the University of Maryland Medical Center in Baltimore.

5. Dennis Hunt is an assistant professor, physical therapy and human performance, and director of the exercise science program at Florida Gulf Coast University, Fort Meyers, Florida.

6. Erika Friedmann is a professor at the University of Maryland, School of Nursing.

7. Mary Kay Hartung was a health sciences librarian at Florida Gulf Coast University. She is now retired.

8. Sue Ann Thomas is a professor emeritus of nursing at the University of Maryland School of Nursing.

Abstract

Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.

Publisher

AACN Publishing

Subject

Critical Care,General Medicine

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