Baseline anxiety and depression among women with cardiovascular risk factors, who were referred to the Women`s Heart Clinic

Background: Robust data correlates psychological factors to the course, outcome and treatment of cardiovascular disease (CVD). However, the presence of these factors among women referred to a woman`s heart clinic (WHC) is unknown.

Hypothesis: Women, who are referred to the WHC, mostly for cardiovascular risk estimation and treatment, will score higher on HADS questionnaire for anxiety and depression (AD), and will report lower quality of life (QOL) compared to hospitalized patients.

Method and Results: 103 women referred to the WHC were evaluated using the HADS questionnaire, assessing AD, and QOL.

The mean age was 58+ 12.6 y (range: 34-87). 72% had CVD risk factors, and 29% had an established CVD. 20% were referred to psychological evaluation, of them, 13 were given a short-term psychological intervention (6-12 sessions).

Analysis of HADS questionnaire scores showed that both AD were higher compared to the reference population. Of interest, the anxiety scores were higher (7.1+4.2) compared to the depression scores (4.1+3.2). Women who were referred to a psychological evaluation, had the highest scores of both depression (M=6.2) and anxiety (M=9.2).

QOL scores was moderate (M=3.5+0.8). Surprisingly there was no significant difference between the women with or without an established CVD.

Conclusions: Women who are referred to the WHC report high level of depression and an even higher level of anxiety. The level of anxiety is close to the borderline abnormal (8 and above), and is higher than hospitalized population. Those women also report sub-optimal quality of life.

Clinical implications:­ This preliminary study contributes to our understanding of the unique psychological aspects of women with either CVD risk factors or overt disease. Our findings emphasize the importance of psychological evaluation among women referred to an out patients` clinic. Further research, as well as improvement in awareness, diagnosis and early intervention is needed.