***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Whether there is an association between depression at the time of acute myocardial infa rct ion and subsequent risk of cardiac complications and death remains controversial . Most studies of this risk factor have been limited to patients of single institutions , and this might account for the varying results . We prospect ively evaluated patients admitted to 5 tertiary care and 5 community hospitals and followed them for 1 year to measure the prevalence and prognostic impact of depressive symptoms after acute myocardial infa rct ion . METHODS Patients were recruited for the study by trained nurse interviewers who had documented acute myocardial infa rct ion within 2 - 3 days of admission . The nurses collected information from the medical records and asked study subjects to complete the  Beck Depression Inventory question naire during their stay in hospital and using a mailed question naire 30 days , 6 months and 1 year later . We obtained information on vital status for patients lost to follow-up from a central death registry . RESULTS Of the 587 study subjects , 550 ( 94 % ) completed the Beck Depression Inventory at baseline and 191 ( 35 % ) had a score of 10 or more , indicating at least mild depression . Rates of depression did not vary over the follow-up period and were similar among patients admitted to tertiary care or community hospitals . Depressed patients were more likely to undergo catheterization ( 57 % v. 47 % , 95 % confidence interval [ CI ] around the difference 0.1%-19.6 % ) and were more likely to undergo percutaneous coronary intervention ( 32 % v. 24 % , 95 % CI around the difference 0.1%-16.2 % ) within 30 days of first admission to hospital . Patients with depression on admission had higher rates of a composite of cardiac complications , including recurrent ischemia , infa rct ion or congestive heart failure during their first stay in hospital or readmission for angina , recurrent acute myocardial infa rct ion , congestive heart failure or arrhythmia ( adjusted hazard ratio 1.4 , 95 % CI 1.05 - 1.86 ) , compared with patients who were not depressed on admission . After 1 year , death rates were higher among patients who were depressed at admission ( 30 patients , 16 % ) compared with nondepressed patients ( 28 patients , 8 % ) , although the difference was not statistically significant ( hazard ratio 1.3 , 95 % CI 0.59 - 3.05 ) . INTERPRETATION Depressive symptoms are common after acute myocardial infa rct ion and are associated with a slight increase in risk of in-hospital catheterization and angiography and readmission because of cardiac complications . Death was infrequent , with no statistically significant difference between the 2 groups Plasma cortisol and platelet serotonin ( 5-hydroxytryptamine , 5-HT ) concentrations were determined in 39 male psychotic and 39 male non-psychotic depressed in patients , and in 69 male healthy control subjects . Psychotic or non-psychotic depressed patients had higher predexamethasone plasma cortisol levels than found in the control group . After the dexamethasone suppression test ( DST ) , psychotic and non-psychotic depressed patients were subdivided into suppressors and non-suppressors . Psychotic and non-psychotic patients had significantly different platelet 5-HT concentrations among themselves and compared with the control group . However , there was no significant correlation between plasma cortisol levels and platelet 5-HT concentrations . Dexamethasone administration did not affect platelet 5-HT concentrations within subtypes of depressed patients . Abnormal cortisol suppression after the DST occurred more frequently in psychotic than in non-psychotic patients . Platelet 5-HT and plasma cortisol concentrations were decreased in patients with pronounced suicidal behaviour . Our results suggest that plasma cortisol and platelet 5-HT concentrations might serve as independent biological markers for different subtypes of depression Background and Purpose — Depression may be a risk factor for cardiovascular disease ( CVD ) mortality . We evaluated long-term mortality risk associated with depressive symptoms measured at middle age among men at high risk for coronary heart disease ( CHD ) . Methods — 12 866 men without definite evidence of CHD at study entry but who had above average risk of CHD based on blood pressure , blood cholesterol levels , and /or cigarette smoking were recruited into the Multiple Risk Factor Intervention Trial ( MRFIT ) . Survivors at the end of the trial were followed-up for mortality for an additional 18 years . Men who had completed the  Center for Epidemiologic Studies Depression ( CES-D ) scale  near the end of the trial ( n=11 216 ) were used in a prospect i ve analysis of post-trial all-cause and cause-specific mortality during 18-year follow-up after CES-D assessment . Results — Greater depressive symptoms measured at the end of the trial were associated with significantly higher risk of all-cause mortality and for cause-specific death , a higher risk of CVD , and , more specifically , stroke mortality ( all P values < 0.02 ) but not CHD mortality ( P=0.48 ) in linear trend analyses . The significant associations were strongest for those reporting the greatest depression : hazard ratio (HR)=1.15 ( 95 % CI , 1.03 to 1.28 ; P<0.01 ) for all-cause mortality for those in the highest depressive symptom quintile , HR=1.21 for CVD mortality ( 95 % CI , 1.03 to 1.41 ; P<0.05 ) , and HR=2.03 for stroke mortality ( 95 % CI , 1.20 to 3.44 ; P<0.01 ) compared with those in the lowest quintile . These associations were adjusted for age , intervention group , race , educational attainment , smoking at baseline and visit 6 , trial averaged systolic blood pressure , alcohol consumption , and fasting cholesterol , as well as the occurrence of nonfatal cardiovascular events during the trial . Conclusions — Greater depressive symptoms are associated with an increase in the risk of all-cause and , more specifically , CVD mortality in men . Stroke but not CHD was the form of CVD with which depressive symptoms were associated Background and Purpose — This study examined depressive disorder as a risk factor for incident stroke  in a prospect i ve , population -based design . Methods — The Baltimore Epidemiologic Catchment Area Study is a prospect i ve 13-year follow-up of a probability sample of household residents from Baltimore , Md.  Depressive disorder  was measured with the  diagnostic interview schedule  , and stroke was assessed by questions from the health interview survey or by documentation on a death certificate . Results — During the 13-year follow-up of 1703 individuals , 66 strokes were reported and 29 strokes were identified by death certificate search . Individuals with a history of depressive disorder were 2.6 times more likely to report stroke than those without this disorder after controlling for heart disease , hypertension , diabetes , and current and previous use of tobacco . Medications used in the treatment of depressive disorder at baseline did not alter this finding . A history of dysthymia demonstrated a similar relationship to stroke , although the estimate was not statistically significant . Conclusions — Depressive disorder is a risk factor for stroke that appears to be independent of traditional cardiovascular risk factors . Further research on mechanisms for the association and the impact of treatment for depressive disorder on subsequent stroke is needed CONTEXT Depressive symptoms predict adverse cardiovascular outcomes in patients with coronary heart disease , but the mechanisms responsible for this association are unknown . OBJECTIVE To determine why depressive symptoms are associated with an increased risk of cardiovascular events . DESIGN AND PARTICIPANTS The Heart and Soul Study is a prospect i ve cohort study of 1017 out patients with stable coronary heart disease followed up for a mean ( SD ) of 4.8 ( 1.4 ) years . SETTING Participants were recruited between September 11 , 2000 , and December 20 , 2002 , from 12 outpatient clinics in the San Francisco Bay Area and were followed up to January 12 , 2008 . MAIN OUTCOME MEASURES Baseline depressive symptoms were assessed using the Patient Health Question naire ( PHQ ) . We used proportional hazards models to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events ( heart failure , myocardial infa rct ion , stroke , transient ischemic attack , or death ) was explained by baseline disease severity and potential biological or behavioral mediators . RESULTS A total of 341 cardiovascular events occurred during 4876 person-years of follow-up . The age-adjusted annual rate of cardiovascular events was 10.0 % among the 199 participants with depressive symptoms ( PHQ score > or = 10 ) and 6.7 % among the 818 participants without depressive symptoms ( hazard ratio [ HR ] , 1.50 ; 95 % confidence interval , [ CI ] , 1.16 - 1.95 ; P = .002 ) . After adjustment for comorbid conditions and disease severity , depressive symptoms were associated with a 31 % higher rate of cardiovascular events ( HR , 1.31 ; 95 % CI , 1.00 - 1.71 ; P = .04 ) . Additional adjustment for potential biological mediators attenuated this association ( HR , 1.24 ; 95 % CI , 0.94 - 1.63 ; P = .12 ) . After further adjustment for potential behavioral mediators , including physical inactivity , there was no significant association ( HR , 1.05 ; 95 % CI , 0.79 - 1.40 ; P = .75 ) . CONCLUSION In this sample of out patients with coronary heart disease , the association between depressive symptoms and adverse cardiovascular events was largely explained by behavioral factors , particularly physical inactivity Aortic pulse wave velocity ( PWV ) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease . Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested . A cohort of 141 subjects ( mean±SD age , 87.1±6.6 years ) was studied in 3 geriatrics departments in a Paris suburb . Together with sphygmomanometric blood pressure measurements , aortic PWV was measured with a vali date d automatic device . During the 30-month follow-up , 56 patients died ( 27 from cardiovascular events ) . Logistic regressions indicated that age ( P = 0.005 ) and a loss of autonomy ( P = 0.01 ) were the best predictors of overall mortality . For cardiovascular mortality , aortic PWV was the major risk predictor ( P = 0.016 ) . The odds ratio was 1.19 ( 95 % confidence interval , 1.03 to 1.37 ) . Antihypertensive drug treatment and blood pressure , including systolic and pulse pressure , had no additive role . In subjects 70 to 100 years old , aortic PWV is a strong , independent predictor of cardiovascular death , whereas systolic or pulse pressure was not . This prospect i ve result will need to be confirmed in an intervention trial BACKGROUND AND PURPOSE Evidence is mounting linking cerebrovascular disease with depressive symptoms in the elderly . Lesions in both white and gray matter have been associated with depressive symptoms and major depression . We sought to investigate the relationship between depressive symptoms and white and gray matter lesions in subjects participating in the Cardiovascular Health Study . METHODS In a sample of 3660 men and women who underwent a st and ardized interview , physical examination , and MRI scan  , we examined the association between number of white and gray matter lesions and white matter grade ( a measure of severity ) and reported depressive symptoms using a modified version of the Centers for Epidemiologic Studies Depression ( CES-D ) scale . We controlled for a variety of demographic and medical variables as well as functional status and Modified Mini-Mental State Examination score . RESULTS The number of small ( <3 mm ) basal ganglia lesions was significantly associated with reported depressive symptoms , but white matter grade was not . In subsequent logistic regression models , number of basal ganglia lesions remained a significant predictor after controlling for non-MRI variables and severity of white matter lesions . CONCLUSIONS Our findings extend previous reports that linked cerebrovascular changes to depressive symptoms in clinical population s to a large community-based population . This report provides further evidence of the importance of basal ganglia lesions in geriatric depression Background Availability of a range of techniques and devices allow measurement of many variables related to the stiffness of large or medium sized arteries . There is good evidence that , pulse wave velocity is a relatively simple measurement and is a good indicator of changes in arterial properties . The pulse wave velocity calculated from pulse wave recording by other methods like doppler or tonometry is tedious , time-consuming and above all their reproducibility depends on the operator skills . It requires intensive re source involvement . For epidemiological studies these methods are not suitable . The aim of our study was to clinical ly evaluate the validity and reproducibility of a new automatic device for measurement of pulse wave velocity that can be used in such studies . Methods In 44 subjects including normal healthy control and patients with coronary artery disease , heart brachial , heart ankle , brachial ankle and carotid femoral 
    Output:
    
A complex pattern of systemic immune activation , endothelial dysfunction and HPA axis hyperactivity is suggestive of the biological relationship between CVD and depression subtypes .