Depression and vascular disease: what is the relationship?

J Affect Disord. 2004 Apr;79(1-3):81-95. doi: 10.1016/S0165-0327(02)00349-X.


Background: the 'vascular depression' hypothesis proposes that vascular disease predisposes to, precipitates or perpetuates depression, and this proposal has stimulated further research into the relationship of depression to vascular disease.

Methods: We investigated the nature of the relationship between depression and vascular diseases by reviewing epidemiological, clinical, neuroimaging and neuropathology studies which have reported on the relationship of depression to coronary artery disease, stroke disease, alterations in blood pressure, vascular dementia, diabetes mellitus and cholesterol levels and by reviewing potential mechanisms by which depression could be associated with vascular diseases.

Results: there is abundant and increasing evidence from these different lines of research that depression has a bidirectional association with vascular diseases and plausible mechanisms exist which explain how depression might increase these vascular diseases and vice versa.

Limitations: this was not a systematic review and so not every report of relevance has been included.

Conclusions: depression has a clear bidirectional relationship with vascular diseases. Further study is needed to clarify the mechanisms involved and to investigate the benefits of conventional and novel treatments for vascular diseases in depressive illness.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Blood Pressure
  • Cholesterol / blood
  • Clinical Trials as Topic
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / psychology
  • Dementia, Vascular / complications
  • Dementia, Vascular / psychology
  • Depressive Disorder / complications*
  • Depressive Disorder / etiology*
  • Diabetes Complications
  • Diabetes Mellitus / psychology
  • Epidemiologic Studies
  • Humans
  • Risk Factors
  • Stroke / complications
  • Stroke / psychology
  • Vascular Diseases / complications*
  • Vascular Diseases / etiology
  • Vascular Diseases / psychology*


  • Cholesterol