Depression and anxiety in cardiovascular disease

Małyszczak, Krzysztof; Rymaszewska, Joanna

doi:10.5603/kp.a2016.0063

Cited by 11 publications

(8 citation statements)

References 44 publications

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“…However, considering the overlap of clinical manifestations, screening instruments, and pharmacological treatments for anxiety and depression, it would be important to manage emotional disorders in patients with acute coronary events in clinical practice. [38][39][40][41] Some implications could be summarised for clinical practice and future research in this field. The potential pathophysiological basis for the association between anxiety and poor prognosis in patients with ACS may include the following: anxiety is a stressor that might further burden cardiac function.…”

Section: Discussionmentioning

confidence: 99%

Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis

Feng

Song

et al. 2020

BMJ Open

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ObjectivesAnxiety has been suggested to be associated with poor outcomes in patients with acute coronary syndrome (ACS). However, results of previous follow-up studies were inconsistent. The aim of this meta-analysis was to evaluate the association between anxiety and clinical outcomes in patients with ACS, and to investigate the potential role of depression underlying the above association.DesignA meta-analysis of prospective follow-up studies.SettingHospitals.ParticipantsPatients with ACS.InterventionsWe included related prospective follow-up studies up through 20 July 2019 that were identified by searching PubMed and Embase databases. A random-effect model was used for the meta-analysis. Anxiety was evaluated by validated instruments at baseline.Primary and secondary outcome measuresWe determined the association between anxiety and risks of mortality and adverse cardiovascular events (MACEs) in patients with ACS.ResultsOur analysis included 17 studies involving 39 038 patients wqith ACS. Anxiety was independently associated with increased mortality risk (adjusted risk ratio (RR) 1.21, 95% CI 1.07 to 1.37, p=0.002) and MACEs (adjusted RR 1.47, 95% CI 1.24 to 1.74, p<0.001) in patients with ACS. Subgroup analyses showed that depression may at least partly confound the association between anxiety and poor outcomes in patients with ACS. Adjustment of depression significantly attenuated the association between anxiety and MACEs (adjusted RR 1.25, 95% CI 1.04 to 1.52, p=0.02). Moreover, anxiety was not significantly associated with mortality risk after adjusting for depression (adjusted RR 0.88, 95% CI 0.66 to 1.17, p=0.37).ConclusionsAnxiety is associated with increased risk of mortality and MACEs in patients with ACS. However, at least part of the association may be confounded by concurrent depressive symptoms in these patients.

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Section: Discussionmentioning

confidence: 99%

Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis

Feng

Song

et al. 2020

BMJ Open

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“…These statistical observations are an important argument supporting the significance of drawing attention to the problem of comorbidity, or co-occurrence of anxiety disorders and cardiovascular diseases. The presence of anxiety disorders makes it more difficult for patients to adapt to a troublesome situation caused by a chronic disease, and is related to lower quality of life, more difficulties in understanding and following medical recommendations, and slower recovery after acute cardiovascular events [76,77,78].…”

Section: The Use Of Beta Blockers In Treating Anxiety Disordersmentioning

confidence: 99%

“…Obecność zaburzeń lękowych utrudnia pacjentom ich adaptację do trudnej sytuacji spowodowanej przewlekłą chorobą i wiąże się z niższą jakością życia, większą trudnością w absorbowaniu i stosowaniu się do zaleceń lekarskich, oraz wolniejszym powrotem do zdrowia po ostrych epizodach sercowo -naczyniowych [76,77,78]. Lęk jest czynnikiem ryzyka rozwoju chorób sercowo -naczyniowych, ale także wystąpienia powikłań zawału serca (arytmie lub kolejne epizody zawału serca) i jest również związany z większą śmiertelnością w tej grupie pacjentów [77].…”

Section: Zastosowanie Beta-adrenolityków W Leczeniu Zaburzeń Lękowychunclassified

The role of beta-adrenolytic drugs in treating anxiety disorders

Brudkowska

Tomczyk

Jusiak

et al. 2018

Curr Probl Psychiatry

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IntroductionBeta blockers are mainly used in treating cardiovascular diseases. However, it has been observed that these drugs have also an anxiolytic potential. Over the years, a number of clinical trials have been conducted aimed at determining the effectiveness of beta blockers in treating anxiety disorders. The aim of the articleThe main objective of the article is to present the significance and position of adrenolytic drugs in the pharmacotherapy of anxiety disorders on the basis of available literature. Moreover, the authors also decided to take into account the data from current research results, considering the problem of side effects of using adrenolytic drugs -especially the controversial reports on their effect on the development of affective disorders. MethodAn analysis was conducted of articles from Medline/PubMed database, selected on the basis of the following key words: anxiety disorders, beta blockers, adrenolytic drugs, as well as on the basis of their dates of publication: 1960-2017. In order to conduct a reliable and complete review of literature, the authors decided to include works from quite an extended period of time. The articles included in the review were published in Polish and English. ResultsThe review of articles concerning the treatment of anxiety disorders clearly suggests that propranolol is effective in reducing the frequency of panic attacks and the tendency for avoidance behavior in patients with agoraphobia. Other studies report on potential benefits in terms of early interventional prevention and treating posttraumatic stress disorder with propranolol. However, there is lack of randomized clinical trials concerning the therapeutic effect of other adrenolytic drugs in treating anxiety disorders. Early research works reported that (mainly lipophilic) beta blockers may have a depressogenic effect; however, the latest studies have not confirmed it. ConclusionsThe contemporary research on the therapeutic potential of beta blockers in treating anxiety disorders is insufficient. What seems to be most promising, however, are reports concerning the desirable effects of using adrenolytic drugs in treating posttraumatic stress disorder, which implicates the necessity of conducting further research verifying the validity of their application. Streszczenie WstępLeki β-adrenolityczne mają główne zastosowanie w leczeniu chorób sercowo-naczyniowych. Zauważono jednak, iż leki te wykazują również potencjał anksjolityczny. Na przestrzeni lat podejmowano kolejne próby kliniczne mające na celu określenie efektywności beta-brokerów w leczeniu zaburzeń lękowych. Cel pracyNadrzędnym celem artykułu jest przedstawienie na podstawie dostępnej literatury, znaczenia i miejsca leków adrenolitycznych w farmakoterapii zaburzeń lękowych. Ponadto, postanowiono również uwzględnić dane płynące z aktualnych wyników badań rozpatrujące problem efektów ubocznych stosowania leków adrenolitycznych -szczególnie kontrowersyjne doniesienia o wpływie beta-blockerów na rozwijanie się zaburzeń afektywnych. Metoda Analizie...

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“…Several studies have indicated an association between anxiety and cardiovascular risk factors and CAD [9]. Anxiety seems to be an adequate predictor of CAD in conjunction with depression [10].…”

Section: Discussionmentioning

confidence: 99%

Atrial electromechanical delay analysed by tissue Doppler echocardiography is prolonged in patients with generalised anxiety disorders

Öksüz¹,

Yarlıoğlueş²,

Öztürk³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground: It has been shown that psychological status is associated with the likelihood of atrial fibrillation (AF). Prolongation of the duration of atrial electromechanical delay (AEMD) is known to be a precursor for AF development.Aim: Therefore, we aimed to evaluate AEMD in patients with anxiety disorder. Methods:In this prospective study, a total of 82 anxiety disorder and 80 healthy subjects were enrolled. Symptoms of anxiety were evaluated by using the Hamilton Anxiety Rating Scale (HAM-A). P-wave dispersion (PWD) was measured on a 12-lead electrocardiogram. Both intra-and inter-AEMD were measured with tissue Doppler imaging. Results:Basal characteristics were similar between the two groups. PWD, inter-and right intra-AEMD were significantly prolonged in patients with anxiety disorders, compared to the control group (p < 0.05). In the correlation analysis, HAM-A was significantly and moderately correlated with right intra-and inter-AEMD, and PWD. Conclusions:Patients suffering from anxiety disorders are characterised by prolonged AEMD, which can provide significant contributions to evaluate the risk for AF development in this group.

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Depression and anxiety in cardiovascular disease

Cited by 11 publications

References 44 publications

Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis

Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis

The role of beta-adrenolytic drugs in treating anxiety disorders

Atrial electromechanical delay analysed by tissue Doppler echocardiography is prolonged in patients with generalised anxiety disorders

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