The Role of Depressive Disorders in Autonomic Cardiovascular Dysregulation in Fibromyalgia, 2022, Reyes del Paso et al

Abstract

Objective
Previous research revealed aberrances in autonomic cardiovascular regulation in fibromyalgia, which may be relevant to symptoms genesis and the increased risk of cardiovascular disorders in individuals with fibromyalgia. This study investigated the role of comorbid depression in autonomic cardiovascular dysregulations in fibromyalgia.

Methods
Cardiovascular recordings were obtained in 53 participants with fibromyalgia who also had depression (N = 27), in participants with fibromyalgia without depression (N = 26) and 29 healthy controls, at rest, and during a cold pressor test and an arithmetic task. Assessed parameters included inter-beat interval, blood pressure, heart rate variability, baroreflex sensitivity, stroke volume, pre-ejection period, left ventricular ejection time, Heather index and total peripheral resistance.

Results
Participants with both fibromyalgia and depression displayed lower tonic inter-beat interval, baroreflex sensitivity and heart rate variability than participants with fibromyalgia without depression and controls (p values <.012, ds: 0.71-1.06). Participants with fibromyalgia but without depression did not differ from controls in these variables. Moreover, participants with fibromyalgia who also had depression, but not those without depression, exhibited lower Heather index, stroke volume and left ventricular ejection time than controls (p values<.013, ds: 0.62-0.78). No group differences arose for pre-ejection period or total peripheral resistance. Stress reactivity was reduced in participants with fibromyalgia, independent of depression, for diastolic blood pressure, inter-beat interval, left ventricular ejection time and heart rate variability, than in controls.

Conclusions
The role of depression in the autonomic dysregulation in fibromyalgia involves chronotropic cardiac control rather than adrenergic influences on contractility and vascular tone. Blunted cardiovascular reactivity may be ascribable to pathological factors inherent to fibromyalgia. These results underline the importance of diagnostics and treatment of comorbid depressive disorders in the management of fibromyalgia.

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I would bet it has far more to do with the reduced activity levels of both groups . some people just cannot see their preconceived ideas as a form of bias that leads to seeing what they want without actually having a logical approach.