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Anxiety and depression linked with angina frequency
2 July 2009
MedWire News: Anxiety and depression are linked with angina in patients with coronary heart disease, a study suggests.
Psychosocial distress was common in those with frequent angina, with nearly half the patients who reported weekly or daily angina having clinically significant anxiety and almost two-thirds having clinically significant depressive symptoms.
Based on the findings, senior author Mark Sullivan (University of Washington School of Medicine, Seattle, USA) suggested physicians should assess patients with frequent angina for anxiety or depression.
“Reducing anxiety and depression may be a cost-effective way to reduce angina,” he said.
The team studied angina frequency in 788 consecutive patients undergoing clinically indicated single-photon emission computed tomography stress perfusion imaging. Patients were also assessed for a broad range of psychosocial characteristics.
Among the 191 patients with established ischemia, who had a mean age of 63 years, 36% reported no angina over the previous 4 weeks, 35% reported monthly symptoms, and 30% had daily or weekly angina.
In multivariable ordinal logistic regression, increasing angina was significantly associated with a history of coronary revascularization (odds ratio [OR]=2.24), anxiety (OR=4.72), and depression (OR=3.12), after adjusting for the amount of inducible ischemia.
Sullivan accepts that it is unclear whether psychosocial factors are truly affecting angina response to ischemia or if the increased chest pain burden is causing an intensification of psychosocial distress.
Nonetheless, his team concludes in the journal Circulation: “At a minimum… the present study highlights the high prevalence of these psychosocial factors among patients with more frequent angina and supports recognition of the presence of these factors so that a proper treatment plan may be developed.”
