Impact of cardiac rehabilitation on anxiety, depression, and health-related quality of life in cardiovascular patients.

INTRODUCTION

The study aimed to evaluate the effects of a cardiac rehabilitation program based on physical exercise and the promotion of healthy habits on anxiety, depression, and health-related quality of life in patients with cardiovascular conditions. Additionally, it sought to analyze the influence of baseline anxiety and depression levels on post-treatment health-related quality of life outcomes.

METHODS

A longitudinal study was conducted with 189 patients who completed a structured cardiac rehabilitation program. Anxiety and depression were assessed using the Goldberg Anxiety and Depression Scale, while health-related quality of life was measured with the RAND-36 survey. Data were collected pre- and post-intervention. Statistical analyses included paired t tests for pre/post-comparisons and ANCOVA to evaluate the impact of initial anxiety and depression on health-related quality of life improvements.

RESULTS

The cardiac rehabilitation program significantly reduced anxiety (mean difference =  - 0.93, CI: - 1.42 to - 0.44, p < 0.001; Cohen's d = 0.35) and depression (mean difference =  - 0.62, CI: - 0.99 to - 0.25, p < 0.001; Cohen's d = 0.32), with improvements observed across several health-related quality of life dimensions, including emotional well-being (p = 0.005) and energy/fatigue (p < 0.001). Baseline anxiety and depression levels influenced changes in specific health-related quality of life dimensions, such as social functioning and role limitations due to physical health (p < 0.05). Causal interpretations are limited by the observational design and absence of a control group.

DISCUSSION: The results show an association between participation in cardiac rehabilitation programs and a reduction in anxiety and depression, as well as improved health-related quality of life in patients with cardiovascular disease. Baseline psychological status plays a key role in determining the magnitude of health-related quality of life improvements, highlighting the need for tailored interventions.