Title: 241: A holistic programme of cardiac rehabilitation is able to improve anxiety and depression in diabetic's men with coronary heart disease
Abstract: The aim of this prospective study was to evaluate the effects of a holistic ambulatory cardiac rehabilitation (CR) program on anxiety and depression in diabetic’men with coronary heart disease (CHD) 275 diabetic’men with CHD (D) and 430 non diabetic’men with CHD (ND) used as control group, with identical age (57.2+-9 / 54 +-55.5 +-11 years respectively) were included in the study. All patients performed a 6-week program including exercise training, psychological screening and support as well as education concerning lifestyle. Reasons of admission were: CABG surgery (45%), angioplasty and stent (41%), angor pectoris or myocardial infarction (14%). Level of anxiety and depression were measured by the psychologist using the Hospital Anxiety and Depression (HAD) scale, before and after the CR program. At baseline, prevalence of anxiety [HAD≥11] was similar in D and ND (31% vs 32%). The prevalence of depression [HAD≥8] was higher in D compared with ND (31% vs 24%, p<0.05) At the end of the program of CR, the entire population studied achieved significant improvements characterised by a statistically significant fall in anxiety/depression (HAD scale). The prevalence of anxiety [HAD≥11] was similar in D and ND (11% both). The prevalence of depression [HAD≥8] was higher but statistically insignificant in D compared with ND (10% vs 6%, p<0.08). Our study confirms that anxiety and depression are frequent in men with CHD. The prevalence of depression is higher in diabetics compared to non diabetics. A holistic CR program including psychological screening and support is able to reduce significantly the level of anxiety and depression in both diabetics and non diabetics’men. Our results emphasize the need to a systematic screening for depression particularly in diabetics and the positive impact of the CR which should be relevant to improve prognosis, even if it is needed to be confirm.