Psychosocial risk factors in relation to other cardiovascular risk factors in coronary heart disease: results from the EUROASPIRE IV survey. A registry from the European Society of Cardiology
File(s)
Author(s)
Type
Journal Article
Abstract
Background
Depression and anxiety are established psychosocial risk factors for coronary heart disease. Contemporary data on their prevalence and associations with other risk factors were evaluated as part of the EUROASPIRE IV survey.
Design
The design of this study was cross-sectional.
Methods
The study group consisted of 7589 patients from 24 European countries examined at a median of 1.4 years after hospitalisation due to coronary heart disease events. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale.
Results
Symptoms of anxiety (Hospital Anxiety and Depression Scale-Anxiety score ≥8) were seen in 26.3% of participants and were more prevalent in women (39.4%) vs men (22.1%). Of the patients, 22.4% (30.6% of women and 19.8% of men) had symptoms of depression (Hospital Anxiety and Depression Scale-Depression score ≥8). Nevertheless, antidepressants and anti-anxiety medications were prescribed to only 2.4% of patients at hospital discharge, and 2.7% and 5.0% of patients, respectively, continued to take them at interview. Both anxiety and depression were associated with female gender, lower educational level and more sedentary lifestyle. Anxiety was more prevalent in younger age groups and depression rates increased with advancing age. Depression was positively associated with current smoking, central obesity and self-reported diabetes. A number of positive lifestyle changes reduced the odds of anxiety and depression.
Conclusions
A substantial proportion of patients have anxiety and depression symptoms after coronary heart disease events but these conditions are undertreated. These disorders, especially depression, are associated with other risk factors, including educational level, sedentary lifestyle, smoking, unhealthy diet and reduced compliance with risk factor modification.
Depression and anxiety are established psychosocial risk factors for coronary heart disease. Contemporary data on their prevalence and associations with other risk factors were evaluated as part of the EUROASPIRE IV survey.
Design
The design of this study was cross-sectional.
Methods
The study group consisted of 7589 patients from 24 European countries examined at a median of 1.4 years after hospitalisation due to coronary heart disease events. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale.
Results
Symptoms of anxiety (Hospital Anxiety and Depression Scale-Anxiety score ≥8) were seen in 26.3% of participants and were more prevalent in women (39.4%) vs men (22.1%). Of the patients, 22.4% (30.6% of women and 19.8% of men) had symptoms of depression (Hospital Anxiety and Depression Scale-Depression score ≥8). Nevertheless, antidepressants and anti-anxiety medications were prescribed to only 2.4% of patients at hospital discharge, and 2.7% and 5.0% of patients, respectively, continued to take them at interview. Both anxiety and depression were associated with female gender, lower educational level and more sedentary lifestyle. Anxiety was more prevalent in younger age groups and depression rates increased with advancing age. Depression was positively associated with current smoking, central obesity and self-reported diabetes. A number of positive lifestyle changes reduced the odds of anxiety and depression.
Conclusions
A substantial proportion of patients have anxiety and depression symptoms after coronary heart disease events but these conditions are undertreated. These disorders, especially depression, are associated with other risk factors, including educational level, sedentary lifestyle, smoking, unhealthy diet and reduced compliance with risk factor modification.
Date Issued
2017-09-01
Date Acceptance
2017-05-02
Citation
European Journal of Preventive Cardiology, 2017, 24 (13), pp.1371-1380
ISSN
2047-4873
Publisher
SAGE Publications
Start Page
1371
End Page
1380
Journal / Book Title
European Journal of Preventive Cardiology
Volume
24
Issue
13
Copyright Statement
© The European Society of Cardiology 2017. The final, definitive version of this paper has been published in European Journal of Preventive Cardiology by Sage Publications Ltd. All rights reserved. It is available at: http://journals.sagepub.com/doi/10.1177/2047487317711334
Sponsor
Imperial College Healthcare NHS Trust - CLRN Funding
Imperial College Healthcare NHS Trust - CLRN Funding
Imperial College Healthcare NHS Trust
Grant Number
WHCP_P46405
RDLRN
RDLRN
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Anxiety
cardiovascular risk
coronary artery disease
depression
ACUTE MYOCARDIAL-INFARCTION
DEPRESSIVE SYMPTOMS
CARDIAC REHABILITATION
PROGNOSTIC ASSOCIATION
METAANALYSIS
ANXIETY
MORTALITY
ADHERENCE
EVENTS
RECOMMENDATIONS
Publication Status
Published
Date Publish Online
2017-05-23