Associations of perceived stress and state anger with symptom burden and functional status in patients with heart...

Area of Science:

• Cardiology
• Psychosomatic Medicine
• Clinical Psychology

Background:

• Psychosocial stress and anger are known cardiovascular event triggers.
• The specific impact of these factors on heart failure (HF) exacerbations remains unclear.
• Understanding these associations is crucial for comprehensive HF management.

Purpose of the Study:

• To investigate the relationship between perceived stress and anger with functional status and symptoms in heart failure (HF) patients.
• To determine if perceived stress or anger is a stronger predictor of HF outcomes.

Main Methods:

• Prospective cohort study (BETRHEART) of 144 HF patients.
• Biweekly assessments of perceived stress (Perceived Stress Scale; PSS) and state anger (STAXI) over 3 months.
• Biweekly objective functional status (6-min walk test; 6MWT) and health status (Kansas City Cardiomyopathy Questionnaire; KCCQ) measurements.

Main Results:

• Higher average perceived stress (PSS) and increases in PSS were linked to worse KCCQ scores.
• Increased PSS was associated with a poorer 6-min walk test (6MWT) performance.
• While anger showed associations, perceived stress emerged as a stronger predictor, with anger's effects potentially mediated by stress.

Conclusions:

• Both perceived stress and anger are significantly associated with poorer functional and health status in HF patients.
• Perceived stress is a more robust predictor of adverse outcomes in this population.
• Anger's detrimental effects on HF status may be partly explained by its influence on psychological stress.