Viola Vaccarino, M.D., Ph.D.
Viola Vaccarino, M.D., Ph.D.
Professor, Emory University, Atlanta, Georgia
Mechanisms Linking Depression to Cardiovascular Risk
Administered by the NHLBI Division of Cardiovascular Sciences, Clinical Applications and Prevention Branch
FY 2009 Recovery Act Funding: $780,847
Research Focus: During a typical visit to a physician's office, mental health is too often ignored, Viola Vaccarino, M.D., Ph. D., contends. "We need to stop thinking of mind and body as two separate entities" she explained. To help move the medical field in this direction, Dr. Vaccarino is conducting a study to determine the relationship between cardiovascular disease and depression.
"The general purpose of our study is to clarify the role of depression and its link to cardiovascular disease," she said. Because depression can be accurately assessed and treatments are available, she says, it is a tempting target for helping improve heart health in patients, as well as for preventing heart disease. If Dr. Vaccarino is able to show a link between depression and heart disease, it could encourage more physicians to pay attention to the signs of depression. Dr. Vaccarino's team will seek to identify any underlying biological factors. Including shared genes, which may link depression and cardiovascular disease. The role of environmental factors, such as exposure to traumatic events, will also be studied.
Although Dr. Vaccarino is known as a leader in women's health research, this particular study examines 80 pairs of male twins who served in the Vietnam War. In each of the pairings, one brother has depression while the other does not. The study sample includes both identical and fraternal twins; by comparing the two sets, the researchers will be able to examine whether genes play a role in the effects of depression on cardiovascular disease.
The twins are part of a registry of about 3,000 pairs of Vietnam Veterans, and represent a pool of research participants that Dr. Vaccarino has studied before. This study will allow researchers to examine the twins again and compare two time points, to see whether the brothers with depression progress to cardiovascular disease more quickly than their twin counterparts without depression. "That would give us a much better clue as to whether there is a true link between depression and heart disease," Dr. Vaccarino said. To determine the extent of cardiovascular disease, researchers are using nuclear scans known as positron emission tomography (PET) to see blood flow through the heart and ultrasounds to measure plaque thickness in the carotid artery.
Economic Impact: The Recovery Act funding allows Dr. Vaccarino and her team to conduct a study that builds upon a previously conducted examination of the same participants. The funding has allowed Dr. Vaccarino and her team to hire a full-time research nurse while keeping existing staff. Without the funding, she said, "We would have had to terminate or cut their time." The money will also be used to support several postdoctoral researchers to help run the program. Some of the funding also helps defray the travel costs of study participants, who come from all over the country to undergo two days of testing.
Interest in Science: After finishing medical school in Milan, Italy, Dr. Vaccarino decided she was not interested in pursuing a career in clinical practice or basic science. While observing the health care system, she realized that many treatment decisions were based on little solid evidence. She viewed the lack of empirical data as a need to help fill in knowledge gaps. Due to a lack of training infrastructure in this field in Italy, she came to the United States to study epidemiology. Dr. Vaccarino's interest in the mind-body connection grew during her doctoral training in epidemiology at Yale University, when she learned about the interconnection between psychological factors and physical disease, particularly heart disease.
Dream Breakthrough Discovery: The mind-body connection is an area Dr. Vaccarino hopes to continue exploring with an aim toward raising awareness among health care providers. "I hope I can prove unequivocally that stress, and other social and emotional factors, can cause heart disease in humans," she said. She admits that this will not be an easy goal to reach, but she hopes this study helps move the field closer to taking a more holistic approach to health care.
By Greg Lavine