Cardiovascular Mortality Affected by Psychological Distress

Persistent moderate psychological distress was associated with an increased risk for cardiovascular (CV) and all-cause mortality in patients with stable coronary artery disease, according to the findings of a recent study.

The study included 950 participants involved in the Long-Term Intervention with Pravastatin in Ischaemic Disease trial. Participants included in the study had completed at least 4 General Health Questionnaires (GHQ) at baseline, and after 6 months, 1, 2 and 4 years, which assessed levels of psychological distress. Persistent distress of any severity level was defined as a consistently reported GHQ score (<5 for mild distress and <10 for moderate distress) on 3 or more occasions over a median of 12.1 years.
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During follow-up, 35 participants (3.7%) reported persistent moderate or greater psychological stress on 3 or more assessments, and had a higher risk for CV death and all-cause mortality compared with patients who reported no distress.

A total of 73 patients (7.7%) reported persistent mild distress on 3 or more assessments, and 255 participants (26.8%) met the criteria for distress on only 1 or 2 assessments. These participants did not have an increased risk for CV or all-cause mortality during follow-up.

“In patients with stable coronary artery disease, persistent psychological distress of at least moderate severity is associated with a substantial increase in CV and all-cause mortality,” the researchers concluded.

—Melissa Weiss

Reference:

Stewart RAH, Colquhoun DM, Marschner SL, et al. Persistent psychological distress and mortality in patients with stable coronary artery disease [published online June 26, 2017]. Heart. doi:10.1136/heartjnl-2016-311097.