Coronary Heart Disease Not a Cheery Condition

MONDAY July 14, 2008 -- A diagnosis of heart disease darkens a person's outlook on life, a new government study finds.

Adults with cardiovascular trouble scored up to 9 percent lower on four scales measuring their quality of life, according to a report in the July 15 issue of Circulation, from researchers at the U.S. Centers for Disease Control and Prevention.

It's not a surprising finding, but it's a necessary study, said Dr. Jipan Xie, who spearheaded the research while a health scientist at the CDC's Division for Heart Disease and Stroke Prevention. She has since left the agency.

"We kind of expected it," Xie said. "Chronic heart disease does affect the quality of life, but we wanted to quantify it, so we would have a benchmark for a national evaluation."

It's important to know how people with heart disease view life because more of them are living longer, Xie said. "With more and more people living with coronary heart disease, we need to further assess the quality-of-life aspect of these patients and help them adjust."

It's something that physicians should pay attention to, Xie said. "When physicians see patients and say 'coronary heart disease,' usually they are not paying enough attention to their quality of life, especially the social aspect."

The CDC study had data on 2,091 people with a history of coronary heart disease in a national sample of 37,386 Americans. On average, those with heart disease scored 2.4 percent lower mental health scores, 9 percent lower self-ratings of health, 9.2 percent lower physical health scores, and 4.6 percent lower on scores of health utility, which measures mobility, self-care, physical activity, pain and anxiety.

The people with coronary heart disease most likely to report poorer quality of life were those aged 18 to 49, women, blacks and Hispanics, the study found.

"In my opinion, younger patients in the workforce may have higher expectations, and heart disease affects their physical performance," Xie said. "They may not be able to perform the job. They are under more pressure than older people."

And women with heart disease "expect to be healthier, so they think their quality of life is more impaired," she said.

But Dr. Winston H. Gandy Jr., a spokesman for the American Heart Association, said that women and minorities feel worse about their heart disease, because their treatment isn't always as good as it could be.

"Disparities exist in the delivery of care," said Gandy, who is director of the Echo/Vascular Center of Excellence of Piedmont Health Institute in Atlanta. "Women and African-Americans in particular present for treatment much later in the course of their disease."

Gandy found a bright side to the study. Results would have been much worse 20 or 30 years ago, before artery-opening techniques such as bypass surgery and angioplasty were commonplace, he said.

"In the early 1980s, there was not a lot of therapy for those issues," Gandy said. "If you had a coronary event, you would be in the hospital for a week and off work for a month. Fast forward to today, and, all of a sudden, we have people who have a heart attack or blockage, get angioplasty today and are home tomorrow."

Ask those people how they feel, and the answer might not be cheerful, Gandy said. "But I'm very encouraged that we have all these people living longer to be around to enjoy their children and grandchildren," he said.

More information

Coronary heart disease and its treatment are described by the U.S. Heart, Lung, and Blood Institute.

Posted: July 2008


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