Miruna Monica PREDA1, Laura Gabriela GAVRIL2, Camelia Cristina DIACONU1,3,4
Abstract. The bidirectional relationship between mental health disorders and cardiovascular disease (CVD) represents a major clinical challenge with significant impact on morbidity and mortality. Patients with coexisting psychiatric and cardiovascular conditions experience a mutually reinforcing deterioration, driven by complex neuroendocrine, autonomic, inflammatory, and metabolic mechanisms. Dysregulation of the hypothalamic–pituitary–adrenal axis promotes water and sodium retention and increases circulating free fatty acids, thereby worsening heart failure. Sympathetic overactivity, elevated catecholamines, and reduced heart rate variability contribute to arrhythmogenesis and myocardial dysfunction. This interplay creates a vicious cycle in which depression and anxiety amplify cardiovascular vulnerability, and cardiovascular disease exacerbates psychiatric symptoms. Integrating mental health evaluation into cardiovascular care is essential for optimizing outcomes, improving treatment adherence, and reducing long-term risk. Comprehensive management includes lifestyle interventions, behavioural support, metabolic monitoring, and psychotropic regimens tailored to the cardiovascular profile. Recognition of the intricate links between psychiatric and cardiovascular pathology underscores the central role of psychocardiology in modern preventive and therapeutic strategies.
Keywords: cardiovascular disease, depression, anxiety, psychiatric drugs, drug interactions.
DOI 10.56082/annalsarscimed.2025.2.11
1Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, Bucharest, Romania
2Department of Anaesthesiology and Intensive Care, Regional Institute of Oncology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
3Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
4Academy of Romanian Scientists
PUBLISHED in Annals of the Academy of Romanian Scientists Series of Medicine, Volume 6, Issue 2