Abstract
The aim of this prospective study was to compare the effects of an ambulatory cardiac rehabilitation program (CRP) on anxiety and depression between women and men. 893 patients, 256 women and 637 men, with identical age (56/55 years respectively) were included. All patients performed a 6-week multidisciplinary holistic CRP including exercise training, psychological screening and support as well as education concerning lifestyle. Reasons of admission were: coronary artery bypass graft surgery (41%), angioplasty & stent (25%), angor pectoris & myocardial infarction (8%), valve replacement (13%), dilated cardiomyopathy (4%), other (9%). Level of anxiety (A) and depression (D) were measured by the psychologist using the Hospital Anxiety and Depression (HAD) scale, before and after the CRP. At baseline, women had a significant higher score for A (11.24 vs 9.02, p<0.001) with a higher prevalence of A [HAD≥11] (57% vs 34% – p<0.001) compared to men. Women had also a significant higher score for D (7.39 vs 5.91 – p<0.001) with a higher prevalence of D [HAD≥8] (44% vs 31% – p<0.001). At the end of the program, the entire population studied achieved significant improvements characterised by a statistically significant fall in anxiety/depression. However, mean fall for A was significantly higher in women (–36% vs –28%, p<0.05) as compared to men. Identical trends was found for D (–54% vs –41%, p<0.05). Consequently, prevalence of A (18% vs 14% – p=0.059) and D (9% vs 9%).were similar in women and men at the end of the rehabilitation. In our study, at baseline, women had a higher level of anxiety and depression compared to men. A holistic rehabilitation program including psychological screening and support is able to reduce significantly the level of anxiety and depression in both women and men. However, women achieved higher improvement. Consequently, at the end of the program, women and men had a similar prevalence for anxiety and depression.
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