The Comorbidity of Depression and Cardiovascular Disease in Midlife Women: Investigating novel biological pathways of risk
2021 Award: $39,617
The risk for developing depression and cardiovascular disease increases significantly in midlife women and this combination of illnesses is a leading cause of disability in this population. Disruption in the physiological pathways involved in stress response may underlie the connection between these illnesses, though this has not been fully studied. The primary objective of this proposal is to examine whether dysfunction in the renin-angiotensin-aldosterone system and autonomic nervous system pathways may be a mechanistic link underlying the association between depression and cardiovascular disease in women.
Need/Problem: Depression and cardiovascular disease (CVD) contribute significantly to the morbidity and mortality of women. About 20% of women are impacted by this comorbidity, which is also the leading cause of disability in women worldwide. The menopausal transition or perimenopause is a period of vulnerability for both depression and CVD, making it a key time to study this critical public health issue.
Grant Summary: We will explore whether disruption in two novel stress pathways 1) the renin-angiotensin-aldosterone system (RAAS) and autonomic nervous system (ANS) and their relationship may underlie the link between depression during the perimenopause (D-MT) and CVD in midlife women.
Goals and Projected Outcomes: This study will provide important insight into potential mechanisms by which D-MT and CVD may be linked in midlife women, which will inform potential risk reduction and treatment strategies that can improve health outcomes in this population.
Margo Nathan, MD
Grant Details: The overarching hypothesis of this pilot study is that the neurobiology of D-MT is associated with alterations in the RAAS and ANS responses to stress that may ultimately contribute to the D-MT/CVD comorbidity in midlife women. To evaluate RAAS and ANS function, we will use an experimental stress paradigm called the Trier Social Stress Test (TSST) to probe these systems. We will recruit women with and without a history of D-MT who will complete the TSST and will collect RAAS hormone levels (aldosterone and angiotensin II) as well as heart rate measurements to evaluate ANS function before and at certain time intervals after the TSST to evaluate group differences in these stress pathways.