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Linkages between anxiety and outcomes in heart failure
Marla J De Jong1, Misook L Chung, Jia-Rong Wu
1TriService Nursing Research Program, Uniformed Services University of the Health Sciences, Frederick, Maryland 21702, USA. mdejong@aol.com
Heart & Lung : the Journal of Critical Care
|April 2, 2011
Summary
High anxiety in heart failure patients is linked to poorer event-free survival, primarily due to medication nonadherence. Interventions targeting anxiety and improving medication adherence may enhance outcomes for heart failure patients.
Area of Science:
- Cardiology
- Psychiatry
- Health Outcomes Research
Background:
- Anxiety is a common comorbidity in heart failure (HF) patients.
- The impact of anxiety on HF outcomes and the underlying mechanisms require further investigation.
Purpose of the Study:
- To examine the relationship between anxiety and event-free survival in HF patients.
- To determine if behavioral and physiological factors mediate the association between anxiety and HF outcomes.
Main Methods:
- A longitudinal study involving 147 HF patients.
- Assessment of anxiety using the Brief Symptom Inventory.
- Measurement of heart-rate variability, plasma norepinephrine, dietary, and medication adherence.
- Follow-up for at least 1 year to assess event-free survival.
Main Results:
- Patients with high anxiety experienced significantly shorter event-free survival (HR, 2.2; P=.03).
- Anxiety independently predicted medication nonadherence (P=.008).
- Medication nonadherence mediated the relationship between anxiety and event-free survival (P=.008).
Conclusions:
- This study demonstrates that medication nonadherence links anxiety to poorer event-free survival in heart failure.
- Interventions aimed at reducing anxiety and improving medication adherence are crucial for enhancing patient outcomes.
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