The influence of age, gender, and race on the prevalence of depression in heart failure patients.
OBJECTIVE
The goal of this study was to determine the prevalence of depression in an out-patient heart failure (HF) population; its relationship to quality of life (QOL); and the impact of gender, race, and age.


BACKGROUND
Most studies of depression in HF have evaluated hospitalized patients (a small percentage of the population) and have ignored the influence of various patient characteristics. Although reported depression rates among hospitalized patients range from 13% to 77.5%, out-patient studies have been small, have reported rates of 13% to 42%, and have not adequately accounted for the impact of age, race, or gender.


METHODS
A total of 155 patients with stable New York Heart Association functional class II, III, and IV HF and an ejection fraction <40% were given questionnaires to assess QOL and depression. These included the Medical Outcomes Study Short Form, the Minnesota Living with Heart Failure questionnaire, and the Beck Depression Inventory (BDI). Depression was defined as a score on the BDI of > or =10.


RESULTS
A total of 48% of the patients scored as depressed. Depressed patients tended to be younger than non-depressed patients. Women were more likely (64%) to be depressed than men (44%). Among men, blacks (34%) tended to have less depression than whites (54%). Depressed patients scored significantly worse than non-depressed patients on all components of both the questionnaires measuring QOL. However, they did not differ in ejection fraction or treatment, except that depressed patients were significantly less likely to be receiving beta-blockers.


CONCLUSIONS
Depression is common in patients with HF, with age, gender, and race influencing its prevalence in ways similar to those observed in the general population. These data suggest that pharmacologic or non-pharmacologic treatment of depression might improve the QOL of HF patients.
Gottlieb
Stephen S
SS
Department of Medicine, University of Maryland School of Medicine, and Baltimore Veterans Administration Medical Center, 21201, USA. sgottlie@medicine.umaryland.edu
Khatta
Meenakshi
M
Friedmann
Erika
E
Einbinder
Lynn
L
Katzen
Scott
S
Baker
Brian
B
Marshall
Joanne
J
Minshall
Stacey
S
Robinson
Shawn
S
Fisher
Michael L
ML
Potenza
Matthew
M
Sigler
Brianne
B
Baldwin
Carissa
C
Thomas
Sue Ann
SA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D044469:Racial Groups; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D011795:Surveys and Questionnaires
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors