BACKGROUND:
Coronary artery disease (CAD) is the leading cause of mortality in women and is responsible for more than 500,000 lives each year in the United States. Depression and depressive symptomatology in healthy subjects increases cardiovascular mortality in both men and women and its prevalence is exponentially rising in women. Research suggests that participation in a cardiac rehabilitation (CR) program reduces depression. Unfortunately studies have shown that CR is widely underutilized, particularly with significantly lower CR enrollment rates among women.
HYPOTHESIS:
The aim of this study was to demonstrate the effect of CR in the improvement of depressive symptoms in female cardiac patients after a cardiovascular event enrolled at the Cardiac Health Center (CHC) New York Hospital Queens (NYHQ).
METHODS:
The study sample comprised of 295 patients who completed 36 visits of CR at CHC NYHQ from 2007-2009. Out of 295 patients (age 66.85 ±10.64), 214 are males (71%) and 81 are females (29%). Mood scores were assessed using the PHQ-9 at the initial visit and again upon completion of the CR program. Of the 81 female patients enrolled, 31 female patients had documented pre and post CR-PHQ scores and of the 214 male patients enrolled, 81male patients had documented pre and post CR-PHQ scores. Using paired t test average mean difference in mood scores was tested.
RESULTS:
There was a significant decrease in mood scores in female patients (7.57 ± 5.18 to 3.11 ± 4.00, Δ 4.45 p= 0.00) compared to male patients (5.72 ± 5.19 to 2.37 ± 3.95 Δ 3.34 p = 0.00) after the completion of CR.
CONCLUSION:
The result of this study confirms that both male and female cardiac patients demonstrated significant reduction in depressive symptoms upon completion of CR. Female cardiac patients reported higher levels of depressive symptoms than male cardiac patients at the beginning of CR and exhibited a significant decrease in mood scores at the end of CR. This evidence supports that CR is an effective treatment in the reduction of depressive symptoms among female cardiac patients. Future studies are needed to establish the relationship among gender, CR, and depression. Clearly this is a complex issue and further efforts are needed to institute strategies to increase participation rates among female cardiac patients.
Szorongás, depresszió, egészségkontrollhit és az egészség-magatartással való kapcsolatuk ischaemiás szívbetegek körében