Exhaustion predicts coronary heart disease independently of symptoms of depression and anxiety in men but not in women

Purpose Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. Methods Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. Results Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. Conclusions This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.

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Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey

European Journal of Preventive Cardiology ◽

10.1177/2047487316667781 ◽

2016 ◽

Vol 24 (1) ◽

pp. 84-91 ◽

Cited By ~ 8

Author(s):

Christof Prugger ◽

Jürgen Wellmann ◽

Jan Heidrich ◽

Dirk De Bacquer ◽

Delphine De Smedt ◽

...

Keyword(s):

Physical Activity ◽

Coronary Heart Disease ◽

Heart Disease ◽

Total Physical Activity ◽

Anxiety And Depression ◽

Regular Exercise ◽

Symptoms Of Depression ◽

Exercise Behaviour ◽

Euroaspire Iii ◽

Exercise Intention

Background Regular exercise lowers the risk of cardiovascular death in coronary heart disease (CHD) patients. We aimed to investigate regular exercise behaviour and intention in relation to symptoms of anxiety and depression in CHD patients across Europe. Design This study was based on a multicentre cross-sectional survey. Methods In the EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events (EUROASPIRE) III survey, 8966 CHD patients <80 years of age from 22 European countries were interviewed on average 15 months after hospitalisation. Whether patients exercised or intended to exercise regularly was assessed using the Stages of Change questionnaire in 8330 patients. Symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. Total physical activity was measured by the International Physical Activity Questionnaire in patients from a subset of 14 countries. Results Overall, 50.3% of patients were not intending to exercise regularly, 15.9% were intending to exercise regularly, and 33.8% were exercising regularly. Patients with severe symptoms of depression less frequently exercised regularly than patients with symptoms in the normal range (20.2%, 95% confidence interval (CI) 14.8–26.8 vs 36.7%, 95% CI 29.8–44.2). Among patients not exercising regularly, patients with severe symptoms of depression were less likely to have an intention to exercise regularly (odds ratio 0.62, 95% CI 0.46–0.85). Symptoms of anxiety did not affect regular exercise intention. In sensitivity analysis, results were consistent when adjusting for total physical activity. Conclusions Lower frequency of regular exercise and decreased likelihood of exercise intention were observed in CHD patients with severe depressive symptoms. Severe symptoms of depression may preclude CHD patients from performing regular exercise.

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P191 The effectiveness of mindfulness-based interventions on perceived stress, depression and anxiety in patients with coronary heart disease: A systematic review and meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehz872.066 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

Author(s):

H Zou ◽

S Y Chair ◽

X Cao

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Active Control ◽

Perceived Stress ◽

Psychological Health ◽

Meta Analysis ◽

Small Sample ◽

Significant Heterogeneity ◽

Depression And Anxiety ◽

Post Intervention

Abstract Background An increasing number of people are living with coronary heart disease (CHD) globally. Psychological conditions such as stress, depression, and anxiety are prevalent for people with CHD, which impose a great challenge for secondary prevention of CHD. Mindfulness-based interventions (MBIs), which incorporate mindfulness skills and cognitive or behavioural therapy, are suggested as a promising approach to help patients with CHD to improve their psychological health. However, the effectiveness of MBIs for patients with CHD has not been systematically reviewed. Purpose To synthesise the evidence regarding the effects of MBIs on reducing perceived stress, depression, and anxiety in patients with CHD. Methods Search was conducted in seven English electronic databases and two Chinese electronic databases from inception to January 2019. Randomized controlled trials (RCTs) that evaluated the effects of MBIs on stress, depression, and anxiety in adults with CHD were included. Two reviewers independently screened records for eligibility, extracted data, and assessed risks of bias using the Cochrane tool. Meta-analysis was conducted by combining the standard mean difference (SMD) with 95% confidence interval (CI) of post-intervention outcome measures using Review Manager Version 5.3. We used a fixed-effects model if no significant heterogeneity (I² < 50%), while in case of significant heterogeneity (50% < I² < 75%), we used a random-effects model. Results Six RCTs involving 473 participants were included. Five of all studies compared MBIs with inactive controls (i.e., usual care and waitlist control). The remaining study utilized a self-help group that received a booklet containing identical mindfulness information as an active control. There were high concerns about the risk of bias across studies, mainly in performance bias and detection bias. The meta-analysis of two studies showed MBIs may reduce perceived stress at post-intervention (SMD -0.82; 95% CI -1.28 to -0.36; P < 0.001; I² 0%) compared with inactive controls. Compared with active control, the single study did not observe a significant reduction of perceived stress in intervention group. The meta-analysis of five studies revealed that MBIs appear effective in reducing depression (SMD -1.08; 95% CI -1.28 to -0.87; P < 0.001; I² 22%) and anxiety (SMD -1.16; 95% CI -1.57 to -0.75; P < 0.001; I² 71%) immediately after intervention, compared with inactive or active controls. Conclusions The results of this review provide evidence for the effects of MBIs on reduction in perceived stress, depression and anxiety at post-intervention in patients with CHD. However, these findings need to be interpreted with caution given the small sample size and methodological limitations within included studies. Rigorous-designed research is urgently needed to further confirm the effectiveness of MBIs on improving psychological health and explore its sustainable effects in patients with CHD.

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