Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.

Watkins, Lana L

Koch, Gary G

Sherwood, Andrew

Blumenthal, James A

Davidson, Jonathan RT

O'Connor, Christopher

Sketch, Michael H

England

2016-12-01T14:35:14Z

2013-03-19

BACKGROUND: Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co-occurrence of depression and anxiety. We examined whether anxiety is associated with increased risk of mortality after accounting for depression in individuals with established CHD. METHODS AND RESULTS: The cohort was composed of 934 men and women with confirmed CHD (mean age, 62±11 years) who completed the Hospital Anxiety and Depression scale (HADS) during hospitalization for coronary angiography. Over the 3-year follow-up period, there were 133 deaths. Elevated scores on the HADS anxiety subscale (HADS-A≥8) were associated with increased risk of mortality after accounting for established risk factors including age, congestive heart failure, left ventricular ejection fraction, 3-vessel disease, and renal disease (hazard ratio [HR], 2.27; 95% CI, 1.55 to 3.33; P<0.001). Elevated scores on the HADS depression subscale (HADS-D≥8) were also associated with increased risk of mortality (HR, 2.18; 95% CI, 1.47 to 3.22; P<0.001). When both psychosocial factors were included in the model, each maintained an association with mortality (anxiety, HR, 1.83; 95% CI, 1.18 to 2.83; P=0.006; depression, HR, 1.66; 95% CI, 1.06 to 2.58; P=0.025). Estimation of the HR for patients with both anxiety and depression versus those with neither revealed a larger HR than for patients with either factor alone (HR, 3.10; 95% CI, 1.95 to 4.94; P<0.001). CONCLUSIONS: Anxiety is associated with increased risk of mortality in CHD patients, particularly when comorbid with depression. Future studies should focus on the co-occurrence of these psychosocial factors as markers of increased mortality risk.

http://www.ncbi.nlm.nih.gov/pubmed/23537805

2/2/e000068

2047-9980

https://hdl.handle.net/10161/13048

eng

Ovid Technologies (Wolters Kluwer Health)

J Am Heart Assoc

10.1161/JAHA.112.000068

Adult

Aged

Aged, 80 and over

Anxiety

Anxiety Disorders

Cause of Death

Cohort Studies

Coronary Disease

Depression

Depressive Disorder

Female

Follow-Up Studies

Humans

Male

Middle Aged

Proportional Hazards Models

Prospective Studies

Risk Factors

Surveys and Questionnaires

Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.

Journal article

Sherwood, Andrew|0000-0001-9067-185X

Blumenthal, James A|0000-0003-3789-0935

http://www.ncbi.nlm.nih.gov/pubmed/23537805

e000068

2

Center for the Study of Aging and Human Development

Clinical Science Departments

Duke

Institutes and Centers

Medicine

Medicine, Cardiology

Medicine, Clinical Pharmacology

Psychiatry & Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine

Psychiatry & Behavioral Sciences, General Psychiatry

Psychology and Neuroscience

School of Medicine

Trinity College of Arts & Sciences

Published online

2