Anxiety and depression in a heart failure population: is there any gender differences?

Abstract Introduction Heart failure (HF) is linked to reduced functioning and health-related quality of life, frequent hospitalizations, and substantial healthcare costs, posing a significant burden on both patients and the healthcare system. Despite advancements in treatment, mortality rates remain high, with approximately 50% of HF patients dying within 5 years of diagnosis. In individuals with HF, psychiatric disorders are widespread, and previous research indicates that these conditions contribute to adverse health and cardiovascular outcomes. The most prevalent psychiatric issues in HF patients include depression and anxiety disorders, with prevalence rates significantly higher than those in the general population. The Hospital Anxiety and Depression Scale (HADS) is a widely used self-report questionnaire designed to assess levels of anxiety and depression, which has been particularly valuable in various medical settings, including cardiology, where it helps healthcare professionals to identify and monitor symptoms of anxiety and depression in patients. Objectives In the general population, both anxiety and depression are more prevalent in women. We aim to assess the existence of gender differences concerning anxiety and depression in our population with HF. Materials and Methods We retrospectively analyzed patients with HF from our HF daily care unit. Results A total of 170 patients were included with a mean age of 68 ± 15 years, with 70% being male. The mean ejection fraction was 34.3%. 31.4% presented with NYHA I, 30.3% with NYHA II, 32.4% with NYHA III, and 5.9% with NYHA IV. Regarding cardiovascular risk factors, 65% had hypertension, 55% had dyslipidemia, 38% had diabetes mellitus, and 38% had a history of myocardial infarction (MI). In our population, 14% had HADS scores over 7 for depression, and 11.2% had HADS scores over 7 for anxiety. Comparing both groups and taking cardiovascular risk factors into consideration, we found that male patients had a higher percentage of active or former smokers (57% vs. 5%, p 0.001). No other differences were found regarding comorbidities. Our study showed that female patients suffer more from anxiety (33% vs. 6%, p 0.001) and depression (30% vs. 12%, p = 0.009) according to the HADS scale. Discussion and Conclusion(s) Anxiety and depression frequently coexist in individuals with heart failure, significantly impacting their quality of life and overall well-being. As evidenced by our study, more than 10% suffer from at least one of these diseases. According to our findings, women appear to be more susceptible to these psychiatric disorders. Therefore, it is crucial to take this into consideration and maintain a lower threshold for suspecting the presence of such disorders.