Depression is a well-established stress-related risk factor for several diseases, mainly for those with cardiovascular outcomes. The mechanisms that link depression disorders with cardiovascular diseases (CVD) include dysfunctions of the autonomic nervous system. Heart rate variability analysis is a widely-used non-invasive method that can simultaneously quantify the activity of the two branches of cardiac autonomic neural control and provide insights about their pathophysiological alterations. Recent scientific literature suggests that sex influences the relationship between depressive symptoms and cardiac autonomic dysfunction. Moreover, a few studies highlight a possible sex paradox: depressed women, despite a greater vagal tone, experience a higher risk of adverse cardiovascular events than depressed men. Although there are striking sex differences in the incidence of depression, scanty data on this topic are available. Lastly, studies on the heart-brain axis bidirectionality and the role of sex are fundamental not only to clarify the biological bases of depression-CVD comorbidity, but also to develop alternative therapies, where vagus nerve appears to be a promising target of non-invasive neuromodulation techniques.

抑郁症是一种公认​​的与压力相关的危险因素，适用于多种疾病，主要是那些患有心血管疾病的疾病。将抑郁症与心血管疾病（CVD）联系起来的机制包括植物神经系统功能障碍。心率变异性分析是一种广泛使用的非侵入性方法，可以同时量化心脏自主神经控制的两个分支的活动，并提供有关其病理生理变化的见解。最近的科学文献表明，性别会影响抑郁症状与心脏自主神经功能障碍之间的关系。此外，一些研究强调了一种可能的性悖论：尽管抑郁症的迷走神经情绪较高，但抑郁的女性比抑郁的男性遭受心血管不良事件的风险更高。尽管抑郁症的发病率存在明显的性别差异，但有关该主题的数据很少。最后，关于心脑轴双向性和性别角色的研究不仅是阐明抑郁症-CVD合并症的生物学基础，而且是开发替代疗法的基础，迷走神经似乎是非侵入性治疗的有希望的靶标神经调节技术。