Associação entre transtorno depressivo maior e doenças cardiovasculares: uma revisão sistemática

Abstract

Depression is considered a psychiatric disorder involving a chronic and recurrent mood disturbance that leads to the development of secondary psychomotor and cognitive changes. It is known that, through mechanisms still not fully understood, there is a close relationship between depressive disorders and the development of cardiometabolic diseases. Therefore, this systematic review aims to analyze the information available in the literature regarding the biological mechanisms linking major depressive disorder (MDD) to the onset of cardiovascular diseases (CVD). The research question was formulated using the PECOS strategy: "What is the relationship between major depressive disorder and cardiovascular diseases?" The search was conducted using only articles published in English between 2022 and 2025. The evidence found in the literature indicates a relationship between both conditions, mediated by factors that contribute to the progression or transition from MDD to CVD. Physiological changes associated with MDD increase oxidative stress, endothelial dysfunction, hypothyroidism, hyperactivity of the sympathoadrenal and hypothalamic-pituitary-adrenal (HPA) axes, blood coagulation risk, and a reduction in the circulation of endothelial progenitor cells. The negative emotions present in MDD are potential stimulators of the sympathetic nervous system that increase the levels of catecholamines, norepinephrine, and pro-inflammatory molecules such as C-reactive protein, IL-6, and TNF-α. It is observed that the difficulty in elucidating the mechanisms linking both conditions is due to a complex interaction of chemical, neurological, molecular, biological, physiological, behavioral, and social factors that hinder their complete understanding. [resumo fornecido pelo autor]