Some Patients in Cardiac Rehab Are Depressed, Anxious, or Stressed: Study

Reviewed by Dr. Victor Marchione, MD.
Written by Mat Lecompte
Published on

Patients enrolled in cardiac rehabilitation may experience depression, anxiety, and stress, which may lead them to drop out. This is according to a new study published on World Mental Health Day in the European Journal of Preventive Cardiology.

Cardiac rehabilitation, also called cardiac rehab, is a medically supervised program designed to improve your cardiovascular health if you have experienced heart attack, heart failure, angioplasty, or heart surgery. Many centers offer a comprehensive range of services to help patients with heart conditions return to a more active lifestyle.

Study author Angela Rao of the University of Technology Sydney, Australia explains: “Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms. They may minimize successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation program.”

“Anxiety may lead to fear of another cardiac event and stop people from being active,’ she continued. ‘Depression and anxiety can also impair the ability to retain new information needed to make health-related behavior changes.”

The study examined the occurrence and impact of anxiety, depression, and stress in patients attending cardiac rehabilitation at two hospitals in Sydney between 2006 and 2017. Researchers followed a total of 4,784 patients who completed the Depression Anxiety Stress Scale questionnaire.

Mental Health Conditions are Related

The results showed that depression, anxiety, and stress were related, with one increasing the likelihood of the other. Patients with stress or anxiety were more than four times more likely to be depressed than those without. It was also found that a was three times more common in patients with depression and over five times more frequent in those with stress.

“Depression can dampen positive intentions to exercise even when receiving support from health professionals and being aware of the benefits,” said Ms. Rao. ‘People with anxiety may underestimate their abilities—for example to walk on a treadmill during a rehabilitation class.”

Rao hopes this study will encourage clinicians to screen for anxiety and depression at the start and end of rehabilitation to identify patients needing extra help. There are many modalities available to help improve mental health and raise participation including stress management, meditation, mindfulness, and cognitive behavioral therapy.

Overall, patents who attend cardiac rehabilitation programs do better than those who don’t. If you have suffered a cardiac event and feel that you may need extra support, physicians advise attending the initial assessment as a first step. Clinicians may be able to help with options that you feel more comfortable with, including completing a home program. The goals of cardiac rehab are to strengthen your heart muscle and get you back to doing the things you love.


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On any matter relating to your health or well-being, please check with an appropriate health professional. No statement herein is to be construed as a diagnosis, treatment, preventative, or cure for any disease, disorder or abnormal physical state. The statements herein have not been evaluated by the Foods and Drugs Administration or Health Canada. Dr. Marchione and the doctors on the Bel Marra Health Editorial Team are compensated by Bel Marra Health for their work in creating content, consulting along with formulating and endorsing products.

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