The Impact of Anxiety, Depression, and Suicidality on Quality of Life and Functional Status of Patients With Congestive Heart Failure and Hypertension: An Observational Cross-Sectional Study



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Objective: Congestive heart failure (CHF) and hypertension are prevalent diseases with high mortality and morbidity rates. Depression and anxiety are frequently associated with cardiovascular diseases. This observational cross-sectional study assessed depression, anxiety, suicidality, and quality of life in 240 patients with CHF (with or without hypertension) or hypertension (without CHF).

Method: Subjects were evaluated between June 2005 and June 2007 using the Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale, Medical Outcomes Study 36-item Short-Form Health Survey (both physical component score and mental component score), and Satisfaction With Life Scale (SWLS). Patients with CHF were assigned a New York Heart Association functional classification.

Results: The CHF patients had higher scores on the depressive factor and the HARS and higher suicidality. Furthermore, they had lower scores on the physical component score, higher scores on the mental component score, and lower scores on the SWLS. Depressive symptom level was a significant predictor of lower physical health (P = .012), whereas anxiety was a significant predictor of satisfaction with life (P = .002). CHF compared to hypertension was a predictor of higher mental health as measured with the mental component score and lower satisfaction with life. Higher anxiety predicted lower satisfaction with life both in patients with CHF and with hypertension.

Conclusions: Anxiety and depressive symptoms and cardiovascular disease were frequently associated. Screening for anxiety and depression in cardiovascular patients may be crucial.

Prim Care Companion J Clin Psychiatry 2010;12(6):e1–e9

Submitted: October 16, 2009; accepted February 16, 2010.

Published online: November 25, 2010 (doi:10.4088/PCC.09m00916gry).

Corresponding author: Gianluca Serafini, MD, Department of Neuroscience, Sapienza University of Rome, Sant’ Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy (

Prim Care Companion J Clin Psychiatry 2010;12(6):e1-e9