Depression and anxiety symptoms affect change in exercise capacity during cardiac rehabilitation

Abstract

Background

To study whether symptoms of depression and anxiety would affect changes in exercise capacity and body mass index (BMI) during rehabilitation.

Design

Comprehensive cardiac outpatient rehabilitation intervention program.

Methods

We investigated exercise capacity, BMI, and symptoms of depression and anxiety before and after cardiac rehabilitation in 114 patients with coronary artery disease. The Hospital Anxiety and Depression Scale (HADS) was applied to assess symptoms of depression (HADS-D) and anxiety (HADS-A).

Results

Exercise capacity increased (127 ± 47 vs. 144 ± 51 watts, P < 0.001) and symptoms of depression (4.0 ± 3.6 vs. 2.7 ± 2.7, P < 0.001) and anxiety (5.4 ± 4.4 vs. 4.1 ± 3.6, P < 0.001) decreased with the program, whereas BMI did not change. After controlling for covariates, HADS-D (r = −0.19, P = 0.47) and HADS-A (r = 0.17, P < 0.09) correlated with change in exercise capacity. Change in HADS-A also correlated with that in exercise capacity (r = 0.18, P < 0.06). Changes in depression and anxiety were not significantly related to those in BMI.

Conclusion

Symptoms of depression and anxiety affected change in exercise capacity during cardiac rehabilitation. Depressive symptoms may impair improvement in exercise capacity, thereby mitigating the cardiovascular benefit achieved by cardiac rehabilitation programs. Eur J Cardiovasc Prev Rehabil 15:704–708 © 2008 The European Society of Cardiology

Keywords

anxiety cardiovascular disease depression exercise rehabilitation risk factor

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