Longitudinal Pathways Between Physical Activity, Depression, and Perceived Stress in Peripheral Artery Disease.

IF 6.9 2区 医学
Idil Yazgan, Victoria Bartlett, Gaëlle Romain, Jacob Cleman, Pamela Petersen-Crair, John A Spertus, Madeleine Hardt, Carlos Mena-Hurtado, Kim G Smolderen
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引用次数: 0

Abstract

Background: One-fifth of the patients with peripheral artery disease (PAD) experience depression and stress. Depression and stress may impact patients' abilities to be physically active, a key recommendation for supporting overall PAD management to improve symptoms and reduce the risk of cardiovascular events. We aimed to study interrelationships between 1-year longitudinal trajectories of depression, stress, and physical activity following a PAD diagnosis.

Methods: Patients with new or worsening PAD symptoms enrolled at 10 US PORTRAIT study (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) vascular specialty clinics (CT, LA, MI, MO, NC, OH, and RI) were assessed at baseline, 3, 6, and 12 months between June 2, 2011 and December 3, 2015. Depressive symptoms were measured with the 8-item Patient Health Questionnaire, perceived stress with the 4-item Perceived Stress Scale and physical activity with items from the INTERHEART study. Path analysis was used to examine the longitudinal relationship between depression and physical activity and perceived stress and physical activity.

Results: A total of 766 patients were included (mean age of 68.2 [±9.4] years; 57.7% male). Overall, 17.8% reported significant depressive symptoms, 36.0% experienced increased perceived stress, and 44.1% were sedentary upon PAD diagnosis. A decrease in physical activity preceded a rise in subsequent depressive symptoms (β ranges -0.45 [95% CI, -0.80 to -0.09]; -0.81 [95% CI, -1.19 to 0.42]) over the course of 1 year. Low physical activity scores at the initial presentation were followed by high perceived stress at 3 months (β=-0.44 [95% CI, -0.80 to -0.07]).

Conclusions: In symptomatic PAD, a decrease in physical activity was followed by an increased risk of depressive symptoms and perceived stress at subsequent intervals over the course of 1 year following PAD diagnosis and treatment. Integrated behavioral health approaches for PAD, addressing physical activity and managing depression or distress, are indicated as collective PAD treatment goals.

外周动脉疾病中体力活动、抑郁和感知压力之间的纵向通路。
背景:五分之一的外周动脉疾病(PAD)患者经历过抑郁和压力。抑郁症和压力可能会影响患者的身体活动能力,这是支持PAD整体管理以改善症状和降低心血管事件风险的关键建议。我们旨在研究PAD诊断后抑郁、压力和身体活动的1年纵向轨迹之间的相互关系。方法:在2011年6月2日至2015年12月3日的基线、3个月、6个月和12个月期间,对参加10项US PORTRAIT研究(以患者为中心的结果与外周动脉疾病治疗实践相关:调查轨迹)血管专科诊所(CT、LA、MI、MO、NC、OH和RI)的PAD新症状或恶化患者进行评估。抑郁症状采用8项患者健康问卷进行测量,感知压力采用4项感知压力量表进行测量,体力活动采用INTERHEART研究项目进行测量。通径分析用于检验抑郁与体力活动、感知压力与体力活动之间的纵向关系。结果:共纳入766例患者(平均年龄68.2[±9.4]岁;57.7%为男性)。总的来说,17.8%的人报告有显著的抑郁症状,36.0%的人感觉压力增加,44.1%的人在PAD诊断后久坐不动。在1年的过程中,体力活动的减少先于随后的抑郁症状的增加(β范围为-0.45[95%CI,-0.80至-0.09];-0.81[95%CI:-1.19至0.42])。最初表现时体力活动得分低,3个月后感知压力高(β=-0.44[95%CI,-0.80--0.07])。结论:在症状性PAD中,在PAD诊断和治疗后的1年内,体力活动减少后,抑郁症状和感知压力的风险增加。PAD的综合行为健康方法,解决身体活动和管理抑郁或痛苦,被认为是PAD的集体治疗目标。
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来源期刊
Circulation. Cardiovascular Quality and Outcomes
Circulation. Cardiovascular Quality and Outcomes Medicine-Cardiology and Cardiovascular Medicine
CiteScore
9.80
自引率
2.90%
发文量
357
期刊介绍: Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, publishes articles related to improving cardiovascular health and health care. Content includes original research, reviews, and case studies relevant to clinical decision-making and healthcare policy. The online-only journal is dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely, and patient-centered care. Through its articles and contributions, the journal equips you with the knowledge you need to improve clinical care and population health, and allows you to engage in scholarly activities of consequence to the health of the public. Circulation: Cardiovascular Quality and Outcomes considers the following types of articles: Original Research Articles, Data Reports, Methods Papers, Cardiovascular Perspectives, Care Innovations, Novel Statistical Methods, Policy Briefs, Data Visualizations, and Caregiver or Patient Viewpoints.
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