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Angina Symptom Burden Associated with Depression Status Among Veterans with Ischemic Heart Disease

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Angina and depression are common in ischemic heart disease (IHD), but their association remains understudied.

Purpose

This study was conducted in order to evaluate the association of 1 year change in depression with change in patient-reported outcomes of stable angina.

Methods

Five hundred sixty-nine stable angina patients completed the Seattle Angina Questionnaire and Patient Health Questionnaire (PHQ) at baseline and 1 year. Participants were divided into four groups: not depressed, new onset of depression at 1 year, remitted at 1 year, and persistently depressed. Associations between depression and angina symptoms were evaluated using regression models.

Results

Compared to those not depressed, newly depressed participants reported more angina (β = −11.7, p < 0.001) and physical limitations (β = −11.8, p < 0.001) and lower treatment satisfaction (β = −15.03, p < 0.001) and quality of life (β = −15.4, p < 0.001). Persistently depressed participants reported physical limitations (β = −7.4, p < 0.05), lower treatment satisfaction (β = −10.1, p < 0.001), and poorer quality of life (β = −10.03, p < 0.001).

Conclusions

Changes in depression scores and angina outcomes were significantly associated.

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Acknowledgments

This work was supported by the Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development (HSR&D) Service, IHI 02-062. Dr. Trivedi is supported by a VA HSR&D Career Development Award (CDA 09-206). VA Puget Sound Health Care System and the VA Palo Alto Health Care System provided resources to support this research. The views expressed in this manuscript are those of the authors and do not necessarily represent the opinions of the Department of Veterans Affairs. Dr. Trivedi and Dr. Sun had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Drs. Ranak Trivedi, Martha Gerrity, John Rumsfeld, John Spertus, Haili Sun, Melanie Doak, Linda Lucas, and Stephan Fihn as well as Ms. Mary McDonell declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. VA Puget Sound Health Care System, Seattle, WA, USA

    Ranak Trivedi PhD, Haili Sun PhD & Mary McDonell MS

  2. Portland VA Medical Center, Portland, OR, USA

    Martha Gerrity MD, PhD, Melanie Doak MD & Linda Lucas MD

  3. Department of Medicine, Oregon Health & Science University, Portland, OR, USA

    Martha Gerrity MD, PhD, Melanie Doak MD & Linda Lucas MD

  4. VA Eastern Colorado Health Care System, Denver, CO, USA

    John S. Rumsfeld MD, PhD

  5. Department of Medicine, University of Missouri-Kansas City, Kansas City, USA

    John A. Spertus MD

  6. Office of Analytics and Business Intelligence, Department of Veterans’ Affairs, Department of Medicine, University of Washington, Seattle, WA, USA

    Stephan D. Fihn MD, MPH

  7. Center for Innovation to Implementation, VA Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University, 795 Willow Rd (MPD-142), Bldg 324, Menlo Park, CA, 94025, USA

    Ranak Trivedi PhD

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  1. Ranak Trivedi PhD
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  2. Martha Gerrity MD, PhD
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  3. John S. Rumsfeld MD, PhD
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  4. John A. Spertus MD
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  7. Melanie Doak MD
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  8. Linda Lucas MD
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  9. Stephan D. Fihn MD, MPH
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Correspondence to Ranak Trivedi PhD.

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Trivedi, R., Gerrity, M., Rumsfeld, J.S. et al. Angina Symptom Burden Associated with Depression Status Among Veterans with Ischemic Heart Disease. ann. behav. med. 49, 58–65 (2015). https://doi.org/10.1007/s12160-014-9629-4

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  • DOI: https://doi.org/10.1007/s12160-014-9629-4

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