Earlier in the month, Pulmonary Hypertension News Contributing Editor Charles Moore reported on how, according to Canada’s Pulmonary Hypertension Association (PHA) Patient and Caregiver Survey, those in Canada diagnosed with pulmonary hypertension (PH) are experiencing serious financial, social, and physical burdens as a result of the disease. Now, a new study involving the New York Heart Association further quantifies the effect of the disease on patients, as those with Pulmonary Arterial Hypertension are found to be adversely affected emotionally as well as physically.
The study, published in J Heart Lung Transplant (2014 Apr 19. pii: S1053-2498(14)01085-7. dpi: 10.1016/j.healun.2014.04.003. [Epub ahead of print]) and outlined on the NIH website, is providing limited but insightful evidence that emotional issues tied to PAH play a major role in health-related quality of life (HRQOL) — a consideration that may need to be further addressed by researchers, physicians, and caregivers throughout the PAH support structure.
In order to measure the emotional impact of depression, anxiety, and stress symptoms as variables in quality of life for PAH patients, the study observed 101 patients in total, 73% of whom were women, all diagnosed with PAH (age, 55.4 ± 16.4 years; 42.6% in New York Heart Association [NYHA] class II). All participants completed a battery of surveys in order to quantify data, including the Depression, Anxiety, and Stress Scale; the generic Medical Outcomes Study Short-Form 36-Item (SF-36) Health Survey; and the disease-specific Minnesota Living With Heart Failure Questionnaire (MLHFQ) HRQOL instrument — all of which are frequently used as diagnostic and study tools. Researchers used a method known as multivariable linear regression analyses to process the data and explore the possible association between emotional issues and HRQOL, with the diagnostics helping to account for demographic and disease-related characteristics in patients.
Of these three sets of study measured, data revealed that patients experienced some kind of negative emotional impact from PAH, such as depression (32.6%), anxiety (48%), or general stress symptoms (27.6%). The NIH abstract notes that, “HRQOL was >1 standard deviation below population norms for the SF-36 Physical Component Summary. Depressive symptoms, NYHA class, and being disabled explained 46% of the total variance of the MLHFQ. Emotional problems did not contribute to the SF-36 Physical Component Summary but explained part of the variance of the physical sub-scales of the SF-36 role limitations due to physical problems, bodily pain, and general health.”
The negative impact of depression, stress, and anxiety in otherwise physically healthy people is well-established in the scientific community. Given this reality, the high occurrence of the three emotional problems among the PAH patient population is a clear signal to doctors that regular screening and possible psychotherapeutic and/or pharmacological treatment is key to mitigating the emotional impact of the disease and improving quality of life in PAH patients.