{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:51:48Z","timestamp":1789959108953,"version":"4.0.1"},"reference-count":90,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Panic Disorder (PD) is a prevalent psychiatric condition characterized by recurrent episodes of acute severe anxiety. These episodes frequently present with symptoms that overlap with those of cardiovascular diseases (CVD), such as elevated blood pressure and chest pain. Despite the prevalence and impact of this comorbidity, the underlying mechanisms are not well understood and remain underexplored. This review synthesizes current understanding and recent findings on the role of 5-hydroxytryptamine (5-HT) in the intersection of PD and vascular dysfunction. 5-HT, a critical inhibitory neurotransmitter, has been implicated in the etiology of PD and linked to panic symptoms. This review underscores the importance of 5-HT in modulating vascular tone through its action on 5-HT1B and 5-HT2A receptors, influencing the production of nitric oxide (NO) and the subsequent vasomotor response. Furthermore, the impact of 5-HT system on platelet activation and aggregation adds another layer to the complex relationship between PD and CVD. Selective serotonin reuptake inhibitors (SSRIs) have shown promise in improving vascular endothelial function. However, the influence of SSRIs on CVD outcomes remains a controversial issue with conflicting findings from various studies. The review also highlights the role of the PI3K\/Akt\/eNOS signaling pathway in 5-HT's influence on vascular endothelial function. In conclusion, the intricate relationship between PD, 5-HT, and vascular endothelial function warrants further investigation. A deeper understanding of these mechanisms could lead to more effective treatments for PD and related CVD, ultimately improving patients\u2019 mental health and cardiovascular outcomes.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1632070","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T05:33:47Z","timestamp":1755668027000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The effects of 5-HT on vascular endothelial dysfunction in patients with panic disorder"],"prefix":"10.3389","volume":"12","author":[{"given":"Yueqi","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqing","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"992","DOI":"10.2174\/1871527313666140612141500","article-title":"Chest pain, panic disorder and coronary artery disease: a systematic review","volume":"13","author":"Soares-Filho","year":"2014","journal-title":"CNS Neurol Disord Drug Targets"},{"key":"B2","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1186\/s12913-017-2493-8","article-title":"The prevalence of non-cardiac chest pain (nccp) using emergency department (ed) data: a northern Ireland based study","volume":"17","author":"McDevitt-Petrovic","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/pra.0000000000000283","article-title":"A brief interview to detect panic attacks and panic disorder in emergency department patients with cardiopulmonary complaints","volume":"24","author":"Sung","year":"2018","journal-title":"J Psychiatr Pract"},{"key":"B4","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12938-022-00985-w","article-title":"Association between mental illness and blood pressure variability: a systematic review","volume":"21","author":"Shahimi","year":"2022","journal-title":"Biomed Eng Online"},{"key":"B5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.cjca.2022.09.005","article-title":"Association between panic attack and coronary ischemia due to reduction in coronary blood flow","volume":"39","author":"Irfan","year":"2023","journal-title":"Can J Cardiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1016\/j.cjca.2023.02.019","article-title":"Do panic attacks causes coronary microvascular spasm?","volume":"39","author":"Lim","year":"2023","journal-title":"Can J Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1002\/da.20654","article-title":"Panic disorder: a review of dsm-iv panic disorder and proposals for dsm-V","volume":"27","author":"Craske","year":"2010","journal-title":"Depress Anxiety"},{"key":"B8","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1146\/annurev-clinpsy-021815-093044","article-title":"Panic disorder comorbidity with medical conditions and treatment implications","volume":"13","author":"Meuret","year":"2017","journal-title":"Annu Rev Clin Psychol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/978-981-32-9705-0_15","article-title":"Anxiety disorders and medical comorbidity: treatment implications","volume":"1191","author":"Meuret","year":"2020","journal-title":"Adv Exp Med Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"105777","DOI":"10.1016\/j.psyneuen.2022.105777","article-title":"Associations of DNA methylation of hpa axis-related genes and neuroendocrine abnormalities in panic disorder","volume":"142","author":"Zou","year":"2022","journal-title":"Psychoneuroendocrinology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1080\/15622975.2016.1181783","article-title":"Biological markers for anxiety disorders, ocd and ptsd\u2014a consensus statement. 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