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Pathophysiological Relationships between Heart Failure and Depression and Anxiety

Author(s): Deborah W. Chapa, Phd, Acnp-Bc, Bimbola Akintade, Phd, Acnp-Bc, Mba, Mha, Heesook Son, Rn, Phd, Mph, Patricia Woltz, Rn, Ms, Dennis Hunt, Edd, Cscs, Erika Friedmann, Phd, Marykay Hartung, Mals, Msph, Sue Ann Thomas, Rn, Phd

Contact Hours 1.00

CERP B 1.00

Pharmacology Hours 0.25

Expires Apr 01, 2018

Topics: Behavioral/Psychosocial, Cardiovascular, Pharmacology

Population: Adult

Role: Staff, APRN

Member: Free
NonMember: $10.00

Added to Collection

Activity Summary

Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.


  • Describe the biopsychosocial holistic model for cardiovascular health
  • Identify 2 neurohormonal pathways and their impact in heart failure
  • Identify nursing implications for heart failure, depression, and anxiety

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.


This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. Approval of a continuing education activity does not imply endorsement by AACN or ANCC of any commercial products displayed or discussed in conjunction with the activity.


The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC's) Commission on Accreditation, ANCC Provider Number 0012 (60 min contact hour). AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing, California Provider number CEP01036 for 1.2 contact hours (50 min contact hour).

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.