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Depressive symptoms and depression have recently been pointed out as additional risk factors for several diseases, including fatal and non-fatal stroke and cardiovascular mortality.1–3 The reason for this association is not clearly understood, and several explanations have been proposed. Some studies found an influence of biological factors, such as increased platelet reactivity, the presence of inflammatory proteins and raised cortisol levels. Others focused on the higher frequency of vascular risk factors in patients with depression, such as hypertension and glucose intolerance, reduced heart rate variability and failure of adrenergic activity regulation. Additionally, some antidepressants can be associated with cardiac arrhythmias and ECG abnormalities. One other possible explanation for the …
Competing interests: None.
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