The Comorbidity of Depression and Cardiovascular Disease in Midlife Women: Investigating Novel Biological Pathways of Risk
University of North Carolina, Chapel Hill
Summary
Depression is a known risk factor for cardiovascular disease (CVD), and this comorbidity contributes significantly to the morbidity and mortality of women. 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. This research will preliminarily 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 these illnesses. Findings will provide important insight into potential mechanisms by which depression during perimenopause may increase risk for CVD in midlife women, which will inform potential risk reduction and treatment strategies that can improve health outcomes in this population.
Description
This study uses an experimental stress task to induce mild social stress and activation of two physiological stress pathways (the RAAS and ANS) that may be be involved in the association between perimenopausal depression and risk for cardiovascular disease in women. Perimenopausal women with mild-moderate depressive symptoms and healthy women without any psychiatric history will be enrolled. All participants will complete the same study procedures. During the first visit (conducted remotely) consent will be obtained. After consent, participants will answer questions about their psychiatric hi…
Eligibility
- Age range
- 44–55 years
- Sex
- Female
- Healthy volunteers
- Yes
Inclusion Criteria: * Women ages 44-55 in the late perimenopause reproductive phase. Perimenopausal status will be determined based on menstrual cycle history. We will enroll women who have had an interval of amenorrhea of at least 60 days but \<1 year consistent with the late menopause transition * Participants in either group may be on antidepressant medications (for any indication), but doses must be stable within 30 days of study participation Exclusion Criteria: * History of bipolar diagnosis or primary psychotic disorder for both groups; prior history of depression in the no-perimenop…
Interventions
- BehavioralTrier Social Stress Test
The TSST has both social-evaluative and arithmetic components. During the social-evaluative component, the participant is asked to prepare and then deliver a brief speech to the research team. After this component there is a surprise arithmetic problem. This challenge paradigm has been well-established to rapidly and robustly induce psychological stress as well as physiological indices of stress (e.g., cortisol response, heart rate response). This task takes approximately 15 minutes to complete.
Location
- University of North Carolina at Chapel HillChapel Hill, North Carolina