Identify three ways that depression might contribute to coronary heart disease (CHD).

Student answers will vary.Key terms and concepts that may be included in student responses:
▪ Depression is associated with reduced heart rate variability (i.e., less variation from heart beat to heart beat), which is an indication of poorer functioning of the autonomic nervous system.In turn, low heart rate variability and other dysfunction of the sympathetic nervous system is a risk factor for CHD.
▪ The activation of the HPA axis and stress hormones, and effects on blood vessels.
▪ Depressed people with CHD are less likely than nondepressed people with CHD to engage in behaviors that could reduce their risk of future cardiac events, such as eating a low-fat diet, not smoking, and increasing their exercise.