Ethnic Variations in Quality of Life and Depressive Symptoms Among Black Americans With Acute Decompensated Heart Failure

Abstract

Readmission rates for black Americans with heart failure are higher than for white Americans. Ethnic variations in quality of life (QOL) and depressive symptoms in black Americans with acute decompensated heart failure (ADHF) are understudied. To assess the severity of depressive symptoms and their contribution to QOL in patients with ADHF receiving care at inner-city hospitals with high volumes of black patients. Depressive symptoms and QOL measured using the Patient Health Questionnaire 9 (PHQ-9) and the Minnesota Living With Heart Failure Questionnaire (MLWHFQ), respectively, were assessed in 134 nonhemodialysis patients with ADHF cared for in neighborhoods of New York City with more than 80% black residents. Univariate and multivariate methods were used to assess the effect of ethnicity on QOL and the contribution of depressive symptoms to QOL. Significant depression (PHQ-9 > or = 10) was found in 45% of individuals; MLWHFQ scores for these patients were 61 +/- 20; 60% of patients were functionally impaired. Adjusted mean QOL scores were equivalent in the African American and Caribbean black groups. Depressive symptoms were equally severe in the 2 groups and explained an equivalent proportion (> 40%) of the variance in QOL in each group. Patients with ADHF cared for at centers with high volumes of black patients may have a high burden of depressive symptoms and a high prevalence of functional impairment because of depressive symptoms. Ethnicity among black Americans with ADHF does not predict QOL or severity of depressive symptoms.