Anxiety sensitivity and fear of exercise in patients attending cardiac rehabilitation

Abstract

BackgroundHabitual engagement in aerobic exercise is critically important for the secondary prevention of cardiovascular disease. Anxiety sensitivity, the fear of anxiety and arousal sensations, is a cognitive factor associated with risk and persistence of anxiety and stress disorders. Anxiety sensitivity has also been linked to various problematic health behaviors, including low levels of physical activity. Thus, anxiety sensitivity may undermine aerobic exercise participation in patients enrolled in cardiac rehabilitation (CR). PurposeThis is the first study to evaluate anxiety sensitivity in patients enrolled in CR, and examine the association between anxiety sensitivity and fears about the negative consequences of exercise. MethodsPatients (n = 69, 68.1% male) were enrolled in an outpatient, medically-supervised, multi-component 12-week CR program. Anxiety sensitivity was assessed with the Anxiety Sensitivity Index-3 (ASI-3). ResultsOn average, patients had completed 5.3 (SD = 3.5) weeks of CR. Scores on the ASI-3 indicated moderate levels of anxiety sensitivity (M = 17.2, SD = 12.3). Moderate and high levels of anxiety sensitivity were present in 43.5% and 31.9% of patients. Anxiety sensitivity was significantly moderately correlated with fear of negative consequences from exercise. After adjusting for relevant covariates, anxiety sensitivity accounted for significant incremental variance in fears of negative consequences from exercise, which was a medium-sized effect. ConclusionsElevated anxiety sensitivity is common in patients enrolled in CR and is associated with greater fears of negative consequences from exercise. Anxiety sensitivity may be an important clinical target in CR to decrease patients’ fears about bodily sensations to promote exercise engagement, and in turn, enhance CR outcomes.