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Treatment of depression in patients with coronary heart disease.

机译:冠心病患者的抑郁症治疗。

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摘要

Depression and coronary heart disease are common conditions that often occur together. Evidence shows that the co-occurrence of these illnesses is not random but driven by depression as a risk factor for the occurrence and progression of coronary heart disease. This link is due, in part, to the impact that depression has on neuroendocrine pathways leading to increased platelet activation, cortisol and catecholamine excess, and altered autonomic nervous system function that influence the pathogenesis and progression of coronary atherosclerosis and subsequent heart disease. We know that treating depression in patients with coronary heart disease improves the symptoms and signs of depression. Evidence is less compelling that treating depression improves the morbidity and mortality of coronary heart disease. However, early findings suggest that some antidepressants may improve the course of coronary heart disease and improve patient compliance with various cardiac interventions. We outline a practical approach to the treatment of depression in patients with coronary heart disease. This approach includes education, counseling, antidepressant drugs, and referral when appropriate.
机译:抑郁症和冠心病是经常同时发生的常见疾病。有证据表明,这些疾病的并发不是随机的,而是由抑郁引起的,而抑郁是冠心病发生和发展的危险因素。这种联系部分归因于抑郁症对神经内分泌途径的影响,该途径导致血小板活化增加,皮质醇和儿茶酚胺过量,以及自主神经系统功能改变,从而影响冠状动脉粥样硬化的发病和进展以及随后的心脏病。我们知道,治疗冠心病患者的抑郁症可以改善抑郁症的症状和体征。没有证据表明抑郁症可以改善冠心病的发病率和死亡率。但是,早期发现表明,某些抗抑郁药可能会改善冠心病的病程并改善患者对各种心脏干预措施的依从性。我们概述了一种治疗冠心病患者抑郁症的实用方法。这种方法包括教育,咨询,抗抑郁药和适当时转诊。

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