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Through effects of catecholamines upon the heart, blood vessels and platelets, sympathoadrenal hyperactivity contributes to the development of cardiovascular diseases in elderly depressed patients. To assess the cardiovascular effect of Citalopram in elderly depressed patients, data from an open multicenter study in Belgium and Luxembourg, in which a total of 811 patients were evaluated, was retrospectively analysed. Although the aim of the study was to assess the efficacy and safety of Citalopram, blood pressure and heart rate were also monitored.Patients included in the study were referred either by psychiatrists, geriatricians or general practitioners. Clinical assessment included ratings on the Hamilton Rating Depression Scale, the Clinical Global Impression Scale, the UKU Side effect rating scale and the assessment of side effects spontaneously reported.With few side effects, Citalopram significantly improves the clinical condition of elderly patients suffering from depressive symptoms. A series of repeated multivariate analyses of covariance were performed on heart rate and blood pressure controlling for the effect of age. Interestingly, a sustained decrease of these parameters was shown during the whole study period reaching significance for systolic blood pressure (p0.05). These effects were observed both in responding as well as non-responding patients, and were somewhat more marked in responders for heart rate (p=0.058).The slight but significant decrease in systolic blood pressure and heart rate suggests that citalopram may reduce sympathoadrenal hyperactivity and the related increased cardiovascular morbidity and mortality associated with depression.