Selina Kikkenborg Berg1, Trine Bernholdt Rasmussen2, Lars Thrysoee3, Charlotte Brun Thorup4, Britt Borregaard5, Anne Vinggaard Christensen6, Rikke Elmose Mols7, Knud Juel8, Ola Ekholm9. 1. Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: selina@rh.dk. 2. Department of Cardiology, Herlev and Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark. Electronic address: trine.bernholdt.rasmussen@regionh.dk. 3. Department of Cardiology, Odense University Hospital, University of Southern Denmark, J.B. Winsløwsvej 4, 5000 Odense C, Denmark. Electronic address: Lars.Thrysoee@rsyd.dk. 4. Department of Cardiology, Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark. Electronic address: cbt@rn.dk. 5. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark. Electronic address: Britt.Borregaard@rsyd.dk. 6. Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: anne.vinggaard.christensen@regionh.dk. 7. Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Blv. 99, 8200 Aarhus N, Denmark. Electronic address: rikkmols@rm.dk. 8. National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark. Electronic address: kj@si-folkesundhed.dk. 9. National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark. Electronic address: oek@si-folkesundhed.dk.
Abstract
OBJECTIVE: To explore (i) the prevalence of cardiac risk factors (obesity, smoking, excessive alcohol consumption and medication non-adherence) among cardiac patients with depression and anxiety, (ii) associations between depression and anxiety scores and cardiac risk factors and (iii) the association of depression and anxiety and cardiac risk factors with mortality, and their population attributable risk. METHODS: A national cross-sectional study using patient-reported outcomes at discharge and national register data. For one year (April 15th 2013 to April 15th 2014) all patients discharged or transferred from the five Danish Heart Centres were included in the study. A total of 14,239 patients answered the HADS questionnaire, response rate 51%. RESULTS: Mean age was 64.8 years and 69% were male. Patients with depression or anxiety (HADS-D or HADS-A score ≥ 8) had 30% and 45%, respectively, higher odds of being current smokers; 19% and 37% higher odds of being obese and 31% and 24% higher odds of excessive alcohol consumption. Depressive patients had 34% higher odds of being non-adherent to their medication. At one-year follow-up, patients with depression (HADS-D score ≥ 11) had the highest attributable risk associated with mortality followed by: smoking, ischemic heart disease, anxiety, diabetes, hypertension chronic obstructive pulmonary disease and excessive alcohol consumption. CONCLUSION: Depression and anxiety in patients with cardiac disease is associated with cardiac risk behaviour such as smoking, obesity, excessive alcohol consumption and medication non-adherence. Depression and anxiety have an attributable risk associated with mortality that is comparable to other well-known risk factors such as smoking.
OBJECTIVE: To explore (i) the prevalence of cardiac risk factors (obesity, smoking, excessive alcohol consumption and medication non-adherence) among cardiac patients with depression and anxiety, (ii) associations between depression and anxiety scores and cardiac risk factors and (iii) the association of depression and anxiety and cardiac risk factors with mortality, and their population attributable risk. METHODS: A national cross-sectional study using patient-reported outcomes at discharge and national register data. For one year (April 15th 2013 to April 15th 2014) all patients discharged or transferred from the five Danish Heart Centres were included in the study. A total of 14,239 patients answered the HADS questionnaire, response rate 51%. RESULTS: Mean age was 64.8 years and 69% were male. Patients with depression or anxiety (HADS-D or HADS-A score ≥ 8) had 30% and 45%, respectively, higher odds of being current smokers; 19% and 37% higher odds of being obese and 31% and 24% higher odds of excessive alcohol consumption. Depressivepatients had 34% higher odds of being non-adherent to their medication. At one-year follow-up, patients with depression (HADS-D score ≥ 11) had the highest attributable risk associated with mortality followed by: smoking, ischemic heart disease, anxiety, diabetes, hypertension chronic obstructive pulmonary disease and excessive alcohol consumption. CONCLUSION:Depression and anxiety in patients with cardiac disease is associated with cardiac risk behaviour such as smoking, obesity, excessive alcohol consumption and medication non-adherence. Depression and anxiety have an attributable risk associated with mortality that is comparable to other well-known risk factors such as smoking.
Authors: Louise Foley; James Larkin; Richard Lombard-Vance; Andrew W Murphy; Lisa Hynes; Emer Galvin; Gerard J Molloy Journal: BMJ Open Date: 2021-09-02 Impact factor: 3.006
Authors: Anne Vinggaard Christensen; Jane K Dixon; Knud Juel; Ola Ekholm; Trine Bernholdt Rasmussen; Britt Borregaard; Rikke Elmose Mols; Lars Thrysøe; Charlotte Brun Thorup; Selina Kikkenborg Berg Journal: Health Qual Life Outcomes Date: 2020-01-07 Impact factor: 3.186
Authors: Trine Bernholdt Rasmussen; Britt Borregaard; Pernille Palm; Rikke Elmose Mols; Anne Vinggaard Christensen; Knud Juel; Ola Ekholm; Charlotte Brun Thorup; Lars Thrysoee; Marie Gjengedal; Selina Kikkenborg Berg Journal: Qual Life Res Date: 2021-07-22 Impact factor: 4.147