Anxiety and depression and secondary prevention of coronary heart disease in 14 countries across six WHO regions: the INTERASPIRE study - Report - MDSpire
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Anxiety and depression and secondary prevention of coronary heart disease in 14 countries across six WHO regions: the INTERASPIRE study
Anxiety, Depression, and Secondary Prevention in Coronary Heart Disease: INTERASPIRE Insights
Overview
The INTERASPIRE study across 14 countries found that increasing severity of anxiety and depression symptoms in patients with coronary heart disease (CHD) is associated with poorer achievement of guideline-recommended secondary prevention targets. Women exhibited higher prevalence and severity of these symptoms, which correlated with worse lifestyle and behavioral risk factors.
Background
Cardiovascular disease (CVD) and depressive disorders are among the top global health burdens, with both conditions increasing significantly in disability-adjusted life years over recent decades. Depression and anxiety are common in patients with CVD, leading to poorer outcomes including increased morbidity, mortality, and reduced quality of life. These mental health conditions negatively impact treatment adherence and accelerate cardiovascular risk factors, complicating secondary prevention efforts. The INTERASPIRE study aimed to evaluate how anxiety and depression affect the achievement of secondary prevention guideline targets in CHD patients worldwide.
Data Highlights
Symptom Category
Adjusted Odds Ratio for Suboptimal INTERASPIRE-GTS
95% Confidence Interval
P Value
Depression Symptoms
1.52
1.13–2.04
0.006
Possible Comorbid Anxiety and Depression
1.57
1.09–2.26
0.015
Probable Comorbid Anxiety and Depression
2.09
1.22–3.57
0.007
Key Findings
Among 4546 CHD patients studied, women had higher prevalence and severity of anxiety and depression symptoms than men.
Severity of anxiety and depression symptoms correlated with increased prevalence of lifestyle and behavioral cardiovascular risk factors.
Patients with depression symptoms had a 52% higher odds of suboptimal achievement of secondary prevention targets.
Those with possible comorbid anxiety and depression had a 57% higher odds, while probable comorbid cases had more than double the odds of suboptimal guideline target achievement.
Increasing severity of mental health symptoms is linked to reduced potential for meeting guideline standards for CHD secondary prevention.
Clinical Implications
Secondary prevention programs for CHD should incorporate risk-stratified management addressing anxiety and depression symptoms to improve adherence to guideline targets. Holistic treatment approaches acknowledging the interplay between mental health and cardiovascular disease are essential, especially given the higher burden of these symptoms in women. Integrating mental health assessment and support into cardiac rehabilitation may enhance lifestyle modification and therapeutic compliance.
Conclusion
The INTERASPIRE study highlights that anxiety and depression significantly impair the achievement of secondary prevention goals in CHD patients globally. Addressing these mental health conditions is critical to optimizing cardiovascular outcomes and requires integrated care strategies.
References
INTERASPIRE Study Group/World Heart Federation/2023 -- The Relationship Between Anxiety, Depression, and Secondary Prevention of Coronary Heart Disease
by Chantal F Ski, Catriona S Jennings, Dirk De Bacquer, Kornelia Kotseva, John William McEvoy, Guy De Backer, Iris Erlund, Sandra Ganly, Terhi Vihervaara, Gregory Yoke Hong Lip, Kausik K Ray, Lars Rydén, Agnieszka Adamska, Ana Abreu, Wael Almahmeed, Ade Meidian Ambari, Junbo Ge, Hosam Hasan-Ali, Yong Huo, Piotr Jankowski, Rodney M Jimenez, Yong Li, Ahmad Syadi Mahmood Zuhdi, Abel Makubi, Amam Chinyere Mbakwem, Lilian Mbau, Jose Luis Navarro Estrada, Okechukwu Samuel Ogah, Elijah Nyainda Ogola, Adalberto Quintero-Baiz, Mahmoud Umar Sani, Maria Ines Sosa Liprandi, Jack Wei Chieh Tan, Miguel Alberto Urina Triana, Tee Joo Yeo, David A Wood, David R Thompson, on behalf of the INTERASPIRE Investigators
