Influence of Depression and Hostility on Exercise Tolerance and Improvement in Patients with Coronary Heart Disease
Biing-Jiun Shen1,2, Jen-Tzer Gau3
1Division of Psychology, Nanyang Technological University, Singapore, 637332, Singapore. bshen@alumni.uchicago.edu.
Insights
Hostility and depression negatively impact exercise in cardiac rehabilitation (CR). Depression mediates hostility
Area of Science:
- Psychosocial factors in cardiovascular disease
- Cardiac rehabilitation outcomes
- Exercise physiology
Background:
- Hostility and depression are associated with poor prognosis in coronary heart disease (CHD).
- Limited research exists on the short-term effects of these psychosocial factors on cardiac rehabilitation (CR) outcomes.
- Understanding these influences is crucial for optimizing patient recovery.
Purpose of the Study:
- To investigate the impact of hostility and depression on exercise tolerance in CHD patients undergoing CR.
- To examine the influence of these factors on the improvement trajectory of exercise capacity over a 6-week period.
- To determine if depression mediates the relationship between hostility and exercise outcomes in CR.
Main Methods:
- Study included 142 patients with CHD (mean age 62 years).
- Latent growth curve modeling was used to analyze baseline exercise tolerance and improvement rates.
- Analyses controlled for age and illness severity, and tested for mediation by depression.
Main Results:
- Higher hostility scores correlated with lower baseline exercise tolerance and slower improvement over 6 weeks.
- Depressive symptom severity mediated the effects of hostility on both baseline exercise capacity and improvement.
- Increased hostility was linked to more severe depressive symptoms, which in turn impaired exercise outcomes.
Conclusions:
- Hostility and depression significantly predict exercise outcomes in cardiac rehabilitation.
- Depression plays a key role in mediating the negative impact of hostility on exercise performance.
- Psychosocial interventions within CR programs are vital for improving CHD patient recovery.
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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