Cardiac rehabilitation programs markedly improve high-risk profiles in coronary patients with high psychological distress

Artham, Surya M., Lavie, Carl J. and Milani, Richard V. (2008) Cardiac rehabilitation programs markedly improve high-risk profiles in coronary patients with high psychological distress. Southern Medical Journal, 101 3: 262-267. doi:10.1097/SMJ.0b013e318164dfa8


Author Artham, Surya M.
Lavie, Carl J.
Milani, Richard V.
Title Cardiac rehabilitation programs markedly improve high-risk profiles in coronary patients with high psychological distress
Journal name Southern Medical Journal   Check publisher's open access policy
ISSN 0038-4348
1541-8243
Publication date 2008-03
Sub-type Article (original research)
DOI 10.1097/SMJ.0b013e318164dfa8
Volume 101
Issue 3
Start page 262
End page 267
Total pages 6
Place of publication Birmingham, AL, United States
Publisher Lippincott Williams & Wilkins
Language eng
Abstract OBJECTIVES: Adverse behavioral profiles, particularly depression and hostility, increase the risk of coronary artery disease (CAD) and affect recovery after CAD events. We sought to determine the effects of outpatient phase II cardiac rehabilitation and exercise training (CRET) programs in CAD patients with high levels of psychological distress. METHODS: We studied 500 consecutive patients both before and after phase II CRET programs and compared 109 patients with the highest quintile of psychological distress (HD) with 115 patients with the lowest quintile of psychological distress (LD). RESULTS: At baseline, patients with HD were younger (P < 0.001), had higher weight (+11%; P < 0.001), body mass indices (BMI) (+9%; P < 0.01), triglycerides (+66%; P < 0.0001), and glycosylated hemoglobin (+9%; P = 0.03), and had higher scores for depression, hostility, anxiety, and somatization (all P < 0.0001), but had lower values for exercise capacity(-15%; P = 0.02), high-density lipoprotein (HDL) cholesterol (-10%; P < 0.01), and total quality of life (QoL) (-26%; P < 0.0001), and all 6 major components of QoL compared with LD. After CRET, patients with HD had significant reductions in weight (-2%; P < 0.01), % fat (-6%; P < 0.001), BMI (-2%, P < 0.01), and scores for anxiety (-49%), depression (-47%), somatization (-34%) and hostility (-38%) (all P < 0.0001), and increases in exercise capacity (+54%; P < 0.0001), HDL cholesterol (+10%; P < 0.0001), and total QoL (+23%; P < 0.0001), and the 6 components of QoL studied. Compared with patients with LD, those with HD had statistically greater improvements in HDL (P = 0.03), triglycerides (P = 0.03), BMI (P = 0.02), as well as all behavioral characteristics and QoL (P < 0.0001), and had similar improvements in all other factors assessed. CONCLUSIONS: These data support the routine assessment of high-risk behavioral characteristics in patients with CAD and demonstrate the marked improvements that occur after phase II CRET programs in CAD patients with high psychological distress.
Keyword cardiopulmonary rehabilitation
coronary artery disease
depression
hostility
psychological distress
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:21:46 EST