The Effect of Autonomic Neural Control on the Cardiovascular System in Patients with Depression

Purpose: In this study, we aimed to examine hearth rate recovery, systolic blood pressure response to exercise and heart rate variability to reveal the effect of autonomic autonomic neural control on the cardiovascular system in depressed individuals. Methods : A total of 151 patients; (49 out of 75 healthy controls and 54 out of 76 patients with depression were females) were associated to age, sex and physical activity. We examined the difference between heart rate at peak exercise and heart rate recovery at related minute. Systolic blood pressure at 2 nd and 3 rd min of recovery was divided into the systolic blood pressure at peak exercise in order to determine blood pressure recovery indices. Results : Heart rate recovery at first minute was significantly lower in the depression group compared to the control group (p <0.0001). The resting systolic blood pressure was similar in both groups (p = 0.762). Systolic blood pressure during peak exercise was significantly higher in the depression group compared to the control group (p <0.0001). In the depressive patient group, the systolic blood pressure recovery index was significantly higher at 2 nd and 3 rd minutes than the control group (p <0.0001, p = 0.015). Time domain and frequency domain parameters significantly decreased compared to the controls. Conclusion: This study demonstrates that depression is characterized with decreased heart rate recovery, exaggerated systolic blood pressure response to exercise and attenuated heart rate variability. These results may also propose alterations in autonomic neuronal control of the cardiovascular system in depression. Amac: Bu calismada, depresyonlu bireylerde otonomik noral kontrolun kardiyovaskuler sistem uzerindeki etkisini ortaya cikarmak icin, kalp atim hizi duzelmesini, egzersize verilen sistolik kan basinci cevabini ve kalp hizi degiskenligini incelemeyi amacladik. Yontem: Toplam 151 hasta (75 saglikli kontrolun 49'u ve depresyonlu 76 hastanin 54'u kadin) yas, cinsiyet ve fiziksel aktivite ile iliskilendirildi. Pik egzersizde kalp atis hizi ile ilgili dakikada gerceklesen  kalp hizi toparlanmasi arasindaki farki inceledik. Toparlanmanin 2. ve 3. dakikasindaki sistolik kan basinci, pik egzersizdeki sistolik kan basincina bolunerek kan basinci toparlanma endeksleri belirlendi. Bulgular: Depresyon grubunda birinci dakikadaki kalp hizi toparlanmasi kontrol grubuna gore anlamli derecede dusuk bulundu (p <0.0001). Istirahat sistolik kan basinci her iki grupta da benzerdi (p = 0.762). Pik egzersiz sirasinda sistolik kan basinci depresyon grubunda kontrol grubuna gore anlamli derecede yuksekti (p <0.0001). Depresif hasta grubunda sistolik kan basincinin toparlanma indeksi kontrol grubuna gore 2. ve 3. dakikalarda daha yuksekti (p <0.0001, p = 0.015). Zaman etki alani ve frekans alani parametreleri, kontrollere kiyasla onemli olcude azaldi. Sonuc: Bu calisma, depresyonun azalmis kalp hizi toparlanmasi, egzersize abartili sistolik kan basinci cevabi ve azalmis kalp hizi degiskenligi ile karakterize oldugunu gostermektedir. Bu sonuclar depresyonda kardiyovaskuler sistemin otonomik noral kontrolunde degisiklikler olabilecegini on gormektedir.