LAUSR

I read with great interest the article by Hagstr€ om et al. [1] about the association between psychosocial stress, such as depressive symptoms, loss of interest, living alone and financial stress, and increased cardiovascular mortality amongst patients with stable coronary heart disease (CHD) despite optimal secondary medical prevention treatment. Although many other contemporary studies have also confirmed the positive correlation of depression with CHD [2, 3], an early description of this association is found in the Deuterocanonical Book of the Christian Old Testament, called, according to the translation of the Seventy (Septuagint), Wisdom of Jesus the Son of Sirach (Codex Alexandrinus) or Wisdom of Sirach (Codex Baticanus), also known as the Book of Ecclesiasticus (Latin Church). This book is a collection of ethical teachings written in original Jewish form by the Jewish scribe ‘Jesus the son of Sirach of Jerusalem’ in Palestine during the Hellenistic period between 190 and 180 BC, although its writing was completed around 170 BC [4]. The grandson of the writer transported the book from Palestine to Egypt and translated it into the Greek language in the year 132 BC [4]. This book is not included amongst the Books of the Hebrew Bible (Jewish Canon), and the complete Jewish original text of the Book was not saved (only fragments have been recovered). According to the biblical Greek fragment ‘ἀpὸ kύpgς cὰq ἐjbaίmeι hάmasος, ja ı kύpg jaqdίaς jάlweι ἰrvύm. ἐm ἐpacxcῇ paqabaίmeι ja ı kύpg, ja ı bίος psxvοῦ jasὰ jaqdίaς. lὴ dῷς e ıς kύpgm sὴm jaqdίam rου, ἀpόrsgrοm aὐsὴm lmgrhe ıς sὰ ἔrvasa’ [Translation: End your sorrow because sorrow causes death, and sorrow of the heart undermines strength (sorrow undermines the strength of the heart). In the sad circumstances of life, sorrow always comes. The life of the poor is a constant sadness of the heart (the life of the poor depresses the heart). But do not let sorrow capture your heart; drive it away and remember that you too will die (remember the last end)] (Wisdom of Sirach 38:18–20) [5]. These biblical verses, which are a part of the thematic paragraph on mourning (see Wisdom of Sirach 38:16–23), clearly refer to the fatal cardiovascular events that could be caused by a prolonged and intense feeling of sorrow (a characteristic feature of depressed mood), as in the case of the death of a beloved person. These verses also indicate the well-known relationship between the low socioeconomic level of a person (‘the life of the poor’) and the occurrence of depressive disorders and cardiovascular events (either directly through an unhealthy lifestyle or indirectly through the mechanisms depression exerts on cardiovascular risk) [6–8]. Moreover, the New Testament report: ‘For the sorrow that is according to the will of God produces a repentance without regret, leading to salvation, but the sorrow of the world produces death.’ (2 Corinthians 7:10).