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Positive attitudes improved outcomes in patients with CAD
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Patients with CAD who have a positive attitude are more likely to exercise and have better survival outcomes, according to a new report.
Researchers evaluated data from the Global Mood Scale and an exercise questionnaire completed by 607 patients with CAD at Holbæk Hospital in Denmark in 2005. The mean age of the patients was 65 years and 75% were men.
At the time of the questionnaires, half (54%) of the patients reported engaging in moderate to intense exercise. High positive affect, as assessed by the Global Mood Scale, was more common in men (P=.002), those with a higher education level (P<.001) and those who were employed (P=.004).
The researchers followed the patients for 5 years. In unadjusted analyses, patients with a high positive affect were more likely to exercise (OR=1.99; 95% CI, 1.44-2.76) and had a reduced risk for all-cause mortality (HR=0.58; 95% CI, 0.37-0.92). After adjustment for age, sex, BMI, psychotropic medication and negative affect, the associations between high positive affect and exercise (OR=1.48; P=0.36) and reduced mortality (HR=0.41; P<.001) remained significant.
During follow-up, 13.2% of patients died. The most common known causes of death were CVD (n=29), cancer (n=14) and respiratory disease (n=6). Thirty patients who died during the study were classified as having high positive affect, whereas 50 had low positive affect. After controlling for positive affect and other variables, the researchers found that patients who exercised were less likely to die during follow-up (HR=0.5; 95% CI, 0.31-0.8; P=.004).
“These results indicate that exercise might act as a mediator in this relationship, independent of demographic and clinical risk factors,” the researchers wrote. “Because positive affect is related to exercise, interventions aimed at positive affect induction in combination with exercise promotion may induce better outcomes for patients, both in terms of increasing the likelihood of the accomplishment and maintenance of a healthy exercise pattern and in terms of better psychological functioning, than interventions focusing on the promotion of exercise alone.”
Disclosure: The researchers report funding from or consultation for AstraZeneca, Boston Scientific, Cameron Health BV, Medtronic, MSD, Pfizer, Sanofi-Aventis and St. Jude Medical.
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