Anxiety and depression and secondary prevention of coronary heart disease in 14 countries across six WHO regions: the INTERASPIRE study.
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Ski Chantal F, Jennings Catriona S, De Bacquer Dirk, Kotseva Kornelia, McEvoy John William, De Backer Guy, Erlund Iris, Ganly Sandra, Vihervaara Terhi, Lip Gregory Yoke Hong, Ray Kausik K, Rydén Lars, Adamska Agnieszka, Abreu Ana, Almahmeed Wael, Ambari Ade Meidian, Ge Junbo, Hasan-Ali Hosam, Huo Yong, Jankowski Piotr, Jimenez Rodney M, Li Yong, Zuhdi Ahmad Syadi Mahmood, Makubi Abel, Mbakwem Amam Chinyere, Mbau Lilian, Estrada Jose Luis Navarro, Ogah Okechukwu Samuel, Ogola Elijah Nyainda, Quintero-Baiz Adalberto, Sani Mahmoud Umar, Liprandi Maria Ines Sosa, Tan Jack Wei Chieh, Triana Miguel Alberto Urina, Yeo Tee Joo, Wood David A, Thompson David R
Аннотация
METHODS: Cross-sectional analysis of the INTERASPIRE study of adults hospitalized in the preceding 6 to 24 months with incident or recurrent CHD who underwent a standardized interview and examination (2020 to 2023) across 14 countries. The main outcome was the INTERASPIRE-Guideline Target Score (GTS); a 10-point assessment of achieving secondary prevention lifestyle, risk factor, and therapeutic targets.
RESULTS: A total of 4546 patients (21.1% women) with a mean (SD) age of 60.0 (10.3) were interviewed. Prevalence's of anxiety and/or depression were greater in women than men, and prevalence of CHD lifestyle and behavioral risk factors increased alongside severity of anxiety and depression symptoms. Compared to those without symptoms, adjusted odds ratios for achieving a suboptimal INTERASPIRE-GTS were: 1.52 (95% CI 1.13-2.04, p = 0.006) for symptoms of depression; 1.57 (95% CI 1.09-2.26, p = 0.015) for 'possible' comorbid anxiety and depression; and 2.09 (95% CI 1.22-3.57, p = 0.007) for those with 'probable' comorbid anxiety and depression.
CONCLUSION: Increasing severity of depression and anxiety symptoms are associated with reduced potential for achieving guideline standards for CHD secondary prevention. Secondary prevention programs should integrate risk-stratified management of individuals with symptoms of anxiety and/or depression to improve CHD guideline targets.