CLINICAL RESEARCH: HEART FAILURE
The influence of age, gender, and race on the prevalence of depression in heart failure patients
Stephen S. Gottlieb, MD, FACC* ,*,
Meenakshi Khatta, RN, CRNP*,
Erika Friedmann, PhD ,
Lynn Einbinder, MD*,
Scott Katzen, MD*,
Brian Baker, BA*,
Joanne Marshall, RN*,
Stacey Minshall, RN*,
Shawn Robinson, MD, FACC*,
Michael L. Fisher, MD, FACC*,
Matthew Potenza, BA*,
Brianne Sigler, BA*,
Carissa Baldwin, BA* and
Sue Ann Thomas, RN, PhD, FAAN
* Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
University of Maryland School of Nursing, Baltimore, Maryland, USA
Brooklyn College, Brooklyn, New York, USA
Baltimore Veterans Administration Medical Center, Baltimore, Maryland, USA
Manuscript received September 11, 2003;
revised manuscript received October 2, 2003,
accepted October 21, 2003.
* Reprint requests and correspondence: Dr. Stephen S. Gottlieb, Division of Cardiology, University of Maryland Medical Systems, 22 South Greene Street, Baltimore, Maryland 21201, USA.
sgottlie{at}medicine.umaryland.edu
OBJECTIVES: The goal of this study was to determine the prevalence of depression in an out-patient heart failure (HF) population; its relationship to quality of life (QOL); and the impact of gender, race, and age.
BACKGROUND: Most studies of depression in HF have evaluated hospitalized patients (a small percentage of the population) and have ignored the influence of various patient characteristics. Although reported depression rates among hospitalized patients range from 13% to 77.5%, out-patient studies have been small, have reported rates of 13% to 42%, and have not adequately accounted for the impact of age, race, or gender.
METHODS: A total of 155 patients with stable New York Heart Association functional class II, III, and IV HF and an ejection fraction <40% were given questionnaires to assess QOL and depression. These included the Medical Outcomes Study Short Form, the Minnesota Living with Heart Failure questionnaire, and the Beck Depression Inventory (BDI). Depression was defined as a score on the BDI of  10.
RESULTS: A total of 48% of the patients scored as depressed. Depressed patients tended to be younger than non-depressed patients. Women were more likely (64%) to be depressed than men (44%). Among men, blacks (34%) tended to have less depression than whites (54%). Depressed patients scored significantly worse than non-depressed patients on all components of both the questionnaires measuring QOL. However, they did not differ in ejection fraction or treatment, except that depressed patients were significantly less likely to be receiving beta-blockers.
CONCLUSIONS: Depression is common in patients with HF, with age, gender, and race influencing its prevalence in ways similar to those observed in the general population. These data suggest that pharmacologic or non-pharmacologic treatment of depression might improve the QOL of HF patients.
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Abbreviations and Acronyms
| | BDI | = Beck Depression Inventory | | CI | = confidence interval | | HF | = heart failure | | MI | = myocardial infarction | | MLWHF | = Minnesota Living With Heart Failure questionnaire | | NYHA | = New York Heart Association | | OR | = odds ratio | | QOL | = quality of life | | SF-36 | = Medical Outcomes Study Short Form |
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