Coronary heart disease patients live longer, but not always happier, lives

July 14, 2008

Better treatments have improved survival in people with coronary heart disease, but the quality of those extra years may be less than ideal, according to research reported in Circulation: Journal of the American Heart Association.

Compared with adults without coronary heart disease (CHD), adults with CHD scored up to 9 percent lower on four scales measuring "quality of life." Patients with coronary heart disease were more likely to say they had poorer quality of life, or describe themselves as sick, said lead author Jipan Xie, M.D., Ph.D., former health scientist in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention in Atlanta, Ga.

Quality of life, which includes physical functioning, psychological functioning, social functioning, overall life satisfaction, and perceptions of health status, can be used to measure effectiveness of treatment and predict the long-term mortality after a cardiac event.

Those most likely to report poorer quality of life in this study were:

-- age 18 to 49;
-- women; and
-- black or Hispanic.

The age-related difference, Xie said, probably reflects a difference in age-related expectations.

"Younger people may feel more pressure — especially younger men — in the workplace and may be more threatened by limitations imposed by their disease," she said.

Older people, especially those who were older than 65, were less likely to say heart disease limited their life or had an adverse effect on their quality of life.

"The implications of these findings underscore the need for interventions aimed at improved health-related quality of life for people with coronary heart disease — a population that has been growing rapidly," she said.

With limited resources, such interventions should be targeted at those populations revealed to be most vulnerable – younger adults, women, blacks and Hispanics, she said.

Xie said the success of interventions to reduce CHD risk and death has set the stage for the challenge of survivorship, in which large numbers of people are living with CHD. For example, she suggested educational efforts aimed at employers to help fashion work environments that would better accommodate employees with heart disease.

About 16 million people in the United States have coronary heart disease, according to the American Heart Association.

The analysis, which used data from the 2000 and 2002 Medical Expenditure Panel Surveys, identified 2,091 people with a history of coronary heart disease from a sample of 37,386 individuals. Researchers say it is the first comparison of quality of life scores between CHD patients and non-CHD patients on a national scale.

On average, CHD patients had 2.4 percent lower mental health scores; 4.6 percent lower health utility scores – which measured mobility, self-care, usual activity, pain and anxiety; 9 percent lower self-ratings of health; and 9.2 percent lower physical health scores.

Researchers noted that men and women with heart disease rated lower on the mental health measure than did participants free of CHD. Yet, while self-rated health scores indicated that men were more affected by CHD than women, physical health scores indicated women with heart disease had more functional impairment than men. Xie said contradictory findings are fairly common in these types of analyses, but the findings suggest a disconnect between self-perception and functional ability.

Researchers said the study is limited because the disease status was self-reported and patients had various stages of CHD and treatments. In addition, there was not enough information to explain the differences in patient-reported health status among demographic subgroups.

Source: American Heart Association

Explore further: India activists back 'pollution tax' to clean Delhi air

Related Stories

India activists back 'pollution tax' to clean Delhi air

October 6, 2015

Environmentalists called Tuesday for a pollution tax in the Indian capital after a top court ordered the city and national governments to quickly come up with a plan to clean New Delhi's notoriously filthy air.

A snapshot of stem cell expression

October 1, 2015

Researchers on the Wellcome Genome Campus reveal new genes involved in stem cell pluripotency, new subpopulations of cells and new methods to find meaning in the data. Published in Cell Stem Cell, the findings have implications ...

It's not a lack of self-control that keeps people poor

September 22, 2015

When considering poverty, our national conversation tends to overlook systemic causes. Instead, we often blame the poor for their poverty. Commentators echo the claim that people are poor because they have bad self-control ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

( -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.