Anxiety in heart failure patients and its association with socio-demographic and clinical characteristics: a cross-sectional study

Filipa M D Costa; Sónia P V Martins; Emilia C T D Moreira; José C M S Cardoso; Lia P N S Fernandes

doi:10.1097/j.pbj.0000000000000177

Anxiety in heart failure patients and its association with socio-demographic and clinical characteristics: a cross-sectional study

Porto Biomed J. 2022 Sep 9;7(4):e177. doi: 10.1097/j.pbj.0000000000000177. eCollection 2022 Jul-Aug.

Authors

Filipa M D Costa¹, Sónia P V Martins^{2

3}, Emilia C T D Moreira³, José C M S Cardoso^{3

4

5}, Lia P N S Fernandes^{2

3

6}

Affiliations

¹ Faculty of Medicine - University of Porto, Porto, Portugal.
² Department of Clinical Neurosciences and Menta Health, Faculty of Medicine - University of Porto, Porto, Portugal.
³ Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine - University of Porto, Porto, Portugal.
⁴ Department of Medicine, Faculty of Medicine - University of Porto, Porto, Portugal.
⁵ Department of Cardiology, Centro Hospitalar Universitário S. João, Porto, Portugal.
⁶ Psychiatry Service, Centro Hospitalar Universitário S. João, Porto, Portugal.

Abstract

Anxiety is one of the most frequent psychiatric disorders in heart failure (HF) patients. However, it is often neglected in clinical practice and studies about the particular relationship with the New York Heart Association (NYHA) classes for HF are scarce. In this context, this study aims to analyze the presence of anxiety symptoms in HF outpatients and also its association with sociodemographic and clinical characteristics of these patients.

Methods: This cross-sectional study is part of the longitudinal Deus Ex-Machina project (NORTE-01-0145-FEDER-000026). HF patients were recruited at an outpatient clinic at a University Hospital. Patients with inability to communicate, severe visual/hearing impairment, or NYHA class IV were excluded. Sociodemographic data and NYHA class were registered. Anxiety was assessed with the 7-item Generalized Anxiety Disorders Scale (with a score ≥10 clinically relevant anxiety). Patients with and without anxiety were compared regarding socio-demographic and clinical variables.

Results: The sample (n = 136) had a median age of 59years (Q₁: 49; Q₃: 68), 66.2% were male and 31.6% presented clinically relevant anxiety. A higher percentage of HF patients with anxiety had psychiatric disorders (58.1% vs 26.9%; P = .001), psychotropic medication (62.8% vs 30.1%; P = .001), and depression (60.5% vs 9.7%; P< .001). No significant differences were found regarding the remaining variables, including NYHA classes.

Conclusions: A substantial proportion of HF patients present clinically relevant anxiety, particularly those with psychiatric history, depressive symptoms, or under psychotropic medication. Therefore, integrating routine screening and treatment of this comorbidity in clinical practice is of utmost importance. Further studies are needed to clarify the association of anxiety with HF.

Keywords: GAD-7; New York Heart Association functional classes; anxiety; heart failure; mental health; psychiatric disorder.