High frequency of anxiety and angina pectoris in depressed women with coronary heart disease |
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| Institution: | 1. Division of Cardiology, Massachusetts General Hospital, Boston, MA;2. Department of Radiology, Massachusetts General Hospital, Boston, MA;3. Department of Biostatistics, Massachusetts General Hospital, Boston, MA;4. Mallinkrodt Institute of Radiology, Washington University, St Louis, MO;5. Department of Emergency Medicine, Baystate Medical Center, Springfield, MA;6. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA;7. Department of Emergency Medicine, Massachusetts General Hospital;8. Department of Emergency Medicine, Baylor College of Medicine, Boston, MA;9. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD;10. Department of Medicine, Brigham and Women''s Hospital, Boston, MA;11. Department of Emergency Medicine, Indiana University, Indianapolis, IN;12. Department of Medicine, Tufts Medical Center, Boston, MA;1. Rheumatology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil;2. Medical Education Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil;3. Research and Development Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil;4. Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil |
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| Abstract: | Background: Depression is an unfavorable state that is difficult to recognize in patients with coronary heart disease (CHD). Little is known about the characteristics of depressed female CHD patients.Objective: The purpose of this study was to investigate the occurrence of depressive symptoms in women entering a cardiac rehabilitation program, and furthermore, to examine whether women who have CHD and depressive symptoms display any unfavorable physical or psychological characteristics that could be helpful in identifying female CHD patients at increased risk of depression.Methods: In a Swedish cross-sectional survey of Swedish women entering a randomized, female cardiac rehabilitation trial, patients with a Beck Depression Inventory (BDI) score indicating depression were compared with patients without depressive symptoms.Results: Of the 121 women with CHD who participated in the study, 23.1% had BDI scores consistent with moderate to severe depression (BDI ≥19). Scores of ≥19 were strongly correlated to established angina pectoris (P = 0.007) and higher rates of anxiety on the Beck Anxiety Inventory (P < 0.001). Depressed women also were more likely to have a family history of heart disease (P = 0.036) and were less likely to care for their health in the future (P = 0.005).Conclusions: This study suggests a strong relationship between depression and angina pectoris in women with CHD. The study also confirms previous findings that depressive symptoms are common in women with CHD. Findings of more pronounced cardiac symptoms in depressed women with CHD suggest that depressive symptoms may present differently or alter cardiac symptoms in female CHD patients. Consequently, the occurrence of increased cardiac symptoms indicates the need to screen for depression, whether depressive symptoms are apparent or not. The higher scores for anxiety in depressed women with CHD and their poorer health care practices, in combination with their more pessimistic beliefs about lifestyle changes, highlight the need to identify depression to enhance adherence to treatment regimens in the cardiac rehabilitation process. |
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