Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.
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1 April 2014
ARTICLE|
April 01 2014
Pathophysiological Relationships Between Heart Failure and Depression and Anxiety
Deborah W. Chapa, PhD, ACNP-BC;
Deborah Chapa is an assistant professor and coordinator of bachelor of nursing science to doctor of nursing practice at George Washington University, School of Nursing, Washington, DC. She is also an acute care nurse practitioner.
Corresponding author: Deborah W. Chapa, phd, acnp-bc, Assistant Professor, George Washington University, School of Nursing, 2010 M St NW, Ste 300, Washington, DC 20036 (e-mail: dchapa@gwu.edu).
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Bimbola Akintade, PhD, ACNP-BC, MBA, MHA;
Bimbola Akintade, PhD, ACNP-BC, MBA, MHA
Bimbola Akintade is an assistant professor in the trauma, critical care, emergency department and clinical nurse specialist nurse practitioner program at the University of Maryland, School of Nursing, and an acute care nurse practitioner at Washington Hospital Center, Baltimore, Maryland.
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Heesook Son, RN, PhD, MPH;
Heesook Son, RN, PhD, MPH
Heesook Son is an assistant professor at Chung-Ang University School of Nursing, Seoul, South Korea.
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Patricia Woltz, RN, MS;
Patricia Woltz, RN, MS
Patricia Woltz is director of nursing research at the University of Maryland Medical Center in Baltimore.
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Dennis Hunt, EDD, CSCS;
Dennis Hunt, EDD, CSCS
Dennis Hunt is an assistant professor, physical therapy and human performance, and director of the exercise science program at Florida Gulf Coast University, Fort Meyers, Florida.
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Erika Friedmann, PhD;
Erika Friedmann, PhD
Erika Friedmann is a professor at the University of Maryland, School of Nursing.
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Mary Kay Hartung, MALS, MSPH;
Mary Kay Hartung, MALS, MSPH
Mary Kay Hartung was a health sciences librarian at Florida Gulf Coast University. She is now retired.
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Sue Ann Thomas, RN,PhD
Sue Ann Thomas, RN,PhD
Sue Ann Thomas is a professor emeritus of nursing at the University of Maryland School of Nursing.
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Crit Care Nurse (2014) 34 (2): 14–25.
Citation
Deborah W. Chapa, Bimbola Akintade, Heesook Son, Patricia Woltz, Dennis Hunt, Erika Friedmann, Mary Kay Hartung, Sue Ann Thomas; Pathophysiological Relationships Between Heart Failure and Depression and Anxiety. Crit Care Nurse 1 April 2014; 34 (2): 14–25. doi: https://doi.org/10.4037/ccn2014938
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