The interaction between anxiety and depressive symptoms on brachial artery reactivity in cardiac patients

• We assess brachial artery reactivity, a proxy of endothelial function.
• We examine brachial artery reactivity with anxiety and depressive symptoms.
• There is an interaction between psychological symptoms and brachial artery reactivity.
• High anxiety and low depressive symptoms were linked to superior brachial artery reactivity.
• High depressive symptoms independent of anxiety were linked to low brachial artery reactivity.

The association between anxiety, depression, and endothelial function (EF) was assessed in a sample of 295 cardiac outpatients (n = 222 men; mean age = 59). Patients were administered the Beck Depression Inventory-II and the State-Trait Anxiety Inventory, trait scale. EF was assessed through forearm hyperemic reactivity, a nuclear medicine variation of the flow-mediated dilatation technique, which calculates the rate of uptake ratio (RUR) between hyperaemic and non-hyperaemic arms. Neither effect of anxiety (F = 1.40, p = .24) nor depression (F = 2.66, p = .10) was found in a model predicting EF, however there was an interaction (F = 4.11, p = .04). Higher anxiety and lower depressive symptoms were associated with superior RUR compared to lower anxiety and lower depressive symptoms. Anxiety had no influence on RUR in those patients with higher depressive symptoms, who generally displayed the lowest levels of RUR, i.e., poor function. It is speculative whether this potential protective role of anxiety may be guided by behavioral or physiological mechanisms.