Self-Reported Everyday Psychosocial Stressors Are Associated With Greater Impairments in Endothelial Function in Young Adults With Major Depressive Disorder

Jody L Greaney, Rachel E Koffer, Erika F H Saunders, David M Almeida, Lacy M Alexander, Jody L Greaney, Rachel E Koffer, Erika F H Saunders, David M Almeida, Lacy M Alexander

Abstract

Background Despite the epidemiological associations between psychological stress, depression, and increased cardiovascular disease risk, no studies have examined the relation between naturally occurring psychosocial stressors and directly measured microvascular function in adults with major depressive disorder ( MDD ). We tested the hypothesis that young adults with MDD exposed to everyday psychosocial stressors would exhibit more severe impairments in endothelium-dependent dilation ( EDD ) compared with: (1) healthy nondepressed adults ( HCs ); and (2) adults with MDD without acute psychosocial stress exposure. Methods and Results Twenty HCs (22±1 years) and 23 otherwise healthy adults with MDD (20±0.3 years) participated in the study. Participants completed a psychosocial experiences survey to document their exposure to any of 6 stressors over the preceding 24 hours (eg, arguments, work stressors). Red cell flux (laser Doppler flowmetry) was measured during graded intradermal microdialysis perfusion of acetylcholine (10-10 to 10-1mol/L). EDD was expressed as a percentage of maximum vascular conductance (flux/mm Hg). Multiple linear regression was used to determine the associations between stress, EDD , and MDD . Adults with MDD reported a greater number and severity of psychosocial stressors compared with HCs (all P<0.05). EDD was blunted in adults with MDD ( HCs : 91±2 versus MDD : 74±3%; P<0.001). Exposure to any stressor was related to more severe impairments in EDD in patients with MDD (no stressor: 81±3 versus 1+ stressors: 69±5%; P=0.04) but not in HCs ( P=0.48). Conclusions These data indicate that exposure to everyday psychosocial stressors is associated with greater impairments in endothelial function in patients with MDD , suggesting a potential mechanistic link between daily stress and depression in increased cardiovascular risk.

Keywords: cardiovascular disease risk factors; depression; nitric oxide; vascular endothelial function.

Figures

Figure 1
Figure 1
Vascular conductance in response to graded perfusion of acetylcholine (A) and during perfusion of the highest concentration of acetylcholine (B) in healthy nondepressed adults (HCs, n=20; filled symbols) and in adults with major depressive disorder (MDD, n=23; open symbols). Endothelium‐dependent dilation was blunted in patients with MDD. Data are mean±standard error. *P<0.05 vs HC.
Figure 2
Figure 2
Vascular conductance during perfusion of the highest concentration of acetylcholine in patients who experienced any psychosocial stressor in the preceding week (1+ stressors) and in those who did not (0 stressors) for all patients (gray symbols; A), healthy nondpressed adults (HCs, n=20; filled symbols; B), and adults with major depressive disorder (MDD, n=23; filled symbols; C). There was a significant interaction between experiencing any psychosocial stressor and depression status in predicting endothelial function (P=0.049). Exposure to a psychosocial stressor was related to more severe impairments in endothelium‐dependent dilation in MDD (P=0.04) but not in HCs (P=0.48). Data are mean±standard error. *P<0.05 vs HCs; †P<0.05 vs 0 stressors.

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