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Influence of Depression and Hostility on Exercise Tolerance and Improvement in Patients with Coronary Heart Disease

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Abstract

Purpose

Although hostility and depression have been linked to higher cardiac risk and poor prognosis of patients with coronary heart disease (CHD), there is a lack of research that studies how they may influence the short-term outcomes among patients participating in cardiac rehabilitation (CR). This study aimed to investigate the influence of hostility and depression on patients’ exercise tolerance and improvement trajectory in a CR program over 6 weeks.

Method

Participants were 142 patients with CHD, with a mean age of 62 years. Latent growth curve modeling was conducted to determine whether hostility and depression predicted patients’ baseline exercise tolerance and rates of improvement on treadmill, while controlling for age and severity of illness. In addition, analysis was conducted to examine whether depression mediated the influence of hostility on exercise outcomes.

Results

Patients with CHD with higher hostility scores had a lower baseline exercise tolerance and slower rates of improvement over 6 weeks. Depressive symptom severity mediated the influence of hostility on exercise baseline and improvement. Patients with higher hostility were more likely to have more severe depressive symptoms, which in turn were associated with lower baseline exercise tolerance and slower improvement.

Conclusion

While both hostility and depression predicted the exercise outcomes in CR, depression explained the influence of hostility. The findings underscore the importance of addressing psychosocial issues in treatment of CHD patients and provide support for psychosocial interventions in CR to facilitate patients’ recovery.

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Acknowledgments

The authors would like to extend our sincere gratitude to Dr. Charles McCreary and Ms. Frances Weber for their support and assistance in completion of this study.

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Authors and Affiliations

  1. Division of Psychology, Nanyang Technological University, Singapore, 637332, Singapore

    Biing-Jiun Shen

  2. Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA

    Biing-Jiun Shen

  3. Department of Geriatric Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA

    Jen-Tzer Gau

Authors
  1. Biing-Jiun Shen
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  2. Jen-Tzer Gau
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Correspondence to Biing-Jiun Shen.

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Both authors declare that there is no conflict of interest to report.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the IRB of Greater LA VA Hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Shen, BJ., Gau, JT. Influence of Depression and Hostility on Exercise Tolerance and Improvement in Patients with Coronary Heart Disease. Int.J. Behav. Med. 24, 312–320 (2017). https://doi.org/10.1007/s12529-016-9598-z

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  • DOI: https://doi.org/10.1007/s12529-016-9598-z

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