Associations of perceived stress and state anger with symptom burden and functional status in patients with heart failure

Endrighi, Romano; Dimond, Andrew J.; Waters, Andrew J.; Dimond, Christopher C.; Harris, Kristie M.; Gottlieb, Stephen S.; Krantz, David S.

doi:10.1080/08870446.2019.1609676

Cited by 15 publications

(21 citation statements)

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“…The present findings demonstrate uniquely that perceived stress and anxiety predict hospitalizations, hospitalizations or death, and worsened health status in HF patients over a 39 month assessment period. Both chronic differences in stress and anxiety level, and episodic changes in perceived stress and anxiety over time are important predictors of hospitalization and worsened health status (23, 25, 27). Risk of hospitalization or death increased by 61% for each 1 SD Mean increase in Perceived Stress, and by 79% for each 1 SD Mean increase in State Anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…Other possible mechanisms emphasize relationships of stress and anxiety to heightened symptoms, somatization, and impaired cognitive function (4, 25, 38-40), thereby increasing likelihood of seeking medical care and hospitalization (4). Increasing symptoms with stress and anxiety might also decrease functional status, interfere with medication and diet compliance, and increase alcohol consumption (4, 13, 40).…”

Section: Discussionmentioning

confidence: 99%

“…At a Baseline visit, after screening and informed consent, assessments included: psychosocial and subjective health questionnaires, walk-test performance, and HF biomarkers (23, 25, 28). At a 3-month clinic visit, all participants repeated the same measures.…”

Section: Methodsmentioning

confidence: 99%

“…The purpose of this study is to determine the long-term chronic and episodic effects of perceived stress, anxiety, and anger as precipitating factors for hospitalizations or death and increased symptom burden in HF patients. To evaluate both chronic and episodic effects (23, 25, 27), we conducted repeated assessments of stress, anxiety, and anger over a 39-month time period, and examined subsequent events (hospitalizations and death), and health status.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Effects of Perceived Stress, Anxiety, and Anger on Hospitalizations or Death and Health Status in Heart Failure Patients

Dimond¹,

Krantz

Waters

et al. 2021

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Background. Chronic and acute stress and emotion predict incidence/recurrence of CHD, but long-term effects on HF exacerbations are poorly understood. This study determined long-term chronic and episodic effects of stress, anxiety, and anger on hospitalizations or death, and worsened health status in HF. Methods and Results. 147 patients with heart failure and reduced ejection fraction (HFrEF) completed measures of perceived stress (Perceived Stress Scale; PSS), state anxiety (STAI), recent anger (RA), and HF-related health status (Kansas City Cardiomyopathy Questionnaire; KCCQ) every 6 months for up to 39 months. Relationships of chronic (Mean) stress and emotion and episodic changes (Deviation) to subsequent hospitalizations or death and health status were determined utilizing Generalized Estimating Equation models. All-cause hospitalizations were predicted by chronic (Mean) PSS (OR=1.06, 95% CI 1.02-1.11, p=0.004), Mean STAI (OR=1.06, 95% CI=1.03, 1.10, p<0.001), and episodic (Deviation) PSS (OR=1.03, 95% CI 1.01-1.06, p=0.022). Mean PSS and Mean STAI also predicted cardiovascular hospitalizations. Each 1 standard deviation increase in Mean PSS and Mean STAI was associated, respectively, with a 61% and 79% increase in hospitalization or death. Anger was not associated with hospitalizations. Poorer KCCQ health status was related to higher Mean and Deviation PSS, STAI, and RA. Relationships to hospitalizations and health status were significant for Anxiety and Perceived Stress, independently of the other psychological measures. Conclusions. In HF patients, chronic perceived stress and anxiety and episodic stress increases are predictive of hospitalizations or death and worsened health status over a >3-year period. Mechanisms may involve sympathetic activation, and/or exacerbations of perceived symptoms or health behaviors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term Effects of Perceived Stress, Anxiety, and Anger on Hospitalizations or Death and Health Status in Heart Failure Patients

Dimond¹,

Krantz

Waters

et al. 2021

Preprint

Self Cite

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“…The program takes into account the heterogeneity of adolescent addictive behaviour by promoting life skills on the one hand and reducing risk behaviours on the other. Addressing four major addictive behaviours among adolescents [ 8 ] as well as two life-skills does not only have the potential to reduce substance and internet use in the short term, but may also lead to increased general self-efficacy and life skills, such as coping with stress, which in the long term might help to prevent further non-communicable diseases and improve well-being [ 41 , 42 ]. In contrast to comprehensive school-based curricula, training and counselling via the ready4life smartphone app is more economic and corresponds with the lifestyle and communication habits of the target group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a smartphone-based coaching program for addiction prevention among apprentices: study protocol of a cluster-randomised controlled trial

et al. 2020

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Background A large proportion of apprentices shows addictive behaviours like cigarette smoking, alcohol, cannabis, or compulsive Internet use, others do not show such behaviours at all. ready4life is a smartphone application-based coaching program for apprentices, which takes into account the heterogeneity of adolescent addictive behaviour by promoting life skills and reducing risk behaviours. The main objective of the planned study is to test the efficacy of ready4life for addiction prevention among apprentices in Switzerland within a controlled trial. Methods/design The efficacy of the ready4life coaching program will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with one follow-up assessment after 6 months. At the beginning of the program, participants of the intervention group will receive an individual profile, showing areas in which they have sufficient resources and in which there is a need for coaching. Based on this feedback, they can select two out of the following six program modules: stress, social skills, Internet use, tobacco/e-cigarettes, cannabis, and alcohol. Participants of the intervention group will receive individualised coaching by a conversational agent (chatbot) for a period of four months. The coaching relies on motivational and social-cognitive principles of behaviour change. Within weekly dialogues, the coach provides individually tailored information in different formats, such as videoclips, texts, or pictures. Study participants will be 1318 apprentices with a minimum age of 15, recruited in approximately 100 vocational school classes in Switzerland. Primary outcome will be a composite measure for addictive behaviours including (1) at risk-drinking, (2) tobacco/e-cigarette smoking, (3) cannabis use, and (4) problematic Internet use. Discussion The study will reveal whether this universally implementable but individually tailored intervention approach is effective in preventing the onset and escalation of addictive behaviors among apprentices. Trial registration ISRCTN59908406 (registration date: 21/10/2020).

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Stress and Cardiovascular Disease

Revankar

Reddy

Chinnaiyan

2022

Contemporary Cardiology

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Associations of perceived stress and state anger with symptom burden and functional status in patients with heart failure

Cited by 15 publications

References 54 publications

Long-term Effects of Perceived Stress, Anxiety, and Anger on Hospitalizations or Death and Health Status in Heart Failure Patients

Long-term Effects of Perceived Stress, Anxiety, and Anger on Hospitalizations or Death and Health Status in Heart Failure Patients

Efficacy of a smartphone-based coaching program for addiction prevention among apprentices: study protocol of a cluster-randomised controlled trial

Stress and Cardiovascular Disease

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