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Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe : results from the EUROASPIRE III survey

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Abstract
Background: Regular exercise lowers the risk of cardiovascular death in coronary heart disease (CHD) patients. We aimed to investigate regular exercise behaviour and intention in relation to symptoms of anxiety and depression in CHD patients across Europe. Design: This study was based on a multicentre cross-sectional survey. Methods: In the EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events (EUROASPIRE) III survey, 8966 CHD patients <80 years of age from 22 European countries were interviewed on average 15 months after hospitalisation. Whether patients exercised or intended to exercise regularly was assessed using the Stages of Change questionnaire in 8330 patients. Symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. Total physical activity was measured by the International Physical Activity Questionnaire in patients from a subset of 14 countries. Results: Overall, 50.3% of patients were not intending to exercise regularly, 15.9% were intending to exercise regularly, and 33.8% were exercising regularly. Patients with severe symptoms of depression less frequently exercised regularly than patients with symptoms in the normal range (20.2%, 95% confidence interval (CI) 14.8–26.8 vs 36.7%, 95% CI 29.8–44.2). Among patients not exercising regularly, patients with severe symptoms of depression were less likely to have an intention to exercise regularly (odds ratio 0.62, 95% CI 0.46–0.85). Symptoms of anxiety did not affect regular exercise intention. In sensitivity analysis, results were consistent when adjusting for total physical activity. Conclusions: Lower frequency of regular exercise and decreased likelihood of exercise intention were observed in CHD patients with severe depressive symptoms. Severe symptoms of depression may preclude CHD patients from performing regular exercise.
Keywords
Coronary heart disease, exercise, physical activity, anxiety, depression, PHYSICAL-ACTIVITY, TRANSTHEORETICAL MODEL, CARDIOVASCULAR EVENTS, RISK, METAANALYSIS, MORTALITY, MODERATE, TRIAL, WOMEN

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Chicago
Prugger, Christof, Jürgen Wellmann, Jan Heidrich, Dirk De Bacquer, Delphine De Smedt, Gui De Backer, Željko Reiner, et al. 2017. “Regular Exercise Behaviour and Intention and Symptoms of Anxiety and Depression in Coronary Heart Disease Patients Across Europe : Results from the EUROASPIRE III Survey.” European Journal of Preventive Cardiology 24 (1): 84–91.
APA
Prugger, C., Wellmann, J., Heidrich, J., De Bacquer, D., De Smedt, D., De Backer, G., Reiner, Ž., et al. (2017). Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe : results from the EUROASPIRE III survey. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 24(1), 84–91.
Vancouver
1.
Prugger C, Wellmann J, Heidrich J, De Bacquer D, De Smedt D, De Backer G, et al. Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe : results from the EUROASPIRE III survey. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. 2017;24(1):84–91.
MLA
Prugger, Christof, Jürgen Wellmann, Jan Heidrich, et al. “Regular Exercise Behaviour and Intention and Symptoms of Anxiety and Depression in Coronary Heart Disease Patients Across Europe : Results from the EUROASPIRE III Survey.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 24.1 (2017): 84–91. Print.
@article{8067688,
  abstract     = {Background: Regular exercise lowers the risk of cardiovascular death in coronary heart disease (CHD) patients. We aimed to investigate regular exercise behaviour and intention in relation to symptoms of anxiety and depression in CHD patients across Europe.
Design: This study was based on a multicentre cross-sectional survey.
Methods: In the EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events (EUROASPIRE) III survey, 8966 CHD patients {\textlangle}80 years of age from 22 European countries were interviewed on average 15 months after hospitalisation. Whether patients exercised or intended to exercise regularly was assessed using the Stages of Change questionnaire in 8330 patients. Symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. Total physical activity was measured by the International Physical Activity Questionnaire in patients from a subset of 14 countries.
Results: Overall, 50.3\% of patients were not intending to exercise regularly, 15.9\% were intending to exercise regularly, and 33.8\% were exercising regularly. Patients with severe symptoms of depression less frequently exercised regularly than patients with symptoms in the normal range (20.2\%, 95\% confidence interval (CI) 14.8--26.8 vs 36.7\%, 95\% CI 29.8--44.2). Among patients not exercising regularly, patients with severe symptoms of depression were less likely to have an intention to exercise regularly (odds ratio 0.62, 95\% CI 0.46--0.85). Symptoms of anxiety did not affect regular exercise intention. In sensitivity analysis, results were consistent when adjusting for total physical activity.
Conclusions: Lower frequency of regular exercise and decreased likelihood of exercise intention were observed in CHD patients with severe depressive symptoms. Severe symptoms of depression may preclude CHD patients from performing regular exercise.},
  author       = {Prugger, Christof and Wellmann, J{\"u}rgen and Heidrich, Jan and De Bacquer, Dirk and De Smedt, Delphine and De Backer, Gui and Reiner, \v{Z}eljko and Empana, Jean-Phillippe and Fras, Zlatko and Gaita, Dan and Jennings, Catriona and Kotseva, Kornelia and Wood, David and Keil, Ulrich},
  issn         = {2047-4873},
  journal      = {EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY},
  keyword      = {Coronary heart disease,exercise,physical activity,anxiety,depression,PHYSICAL-ACTIVITY,TRANSTHEORETICAL MODEL,CARDIOVASCULAR EVENTS,RISK,METAANALYSIS,MORTALITY,MODERATE,TRIAL,WOMEN},
  language     = {eng},
  number       = {1},
  pages        = {84--91},
  title        = {Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe : results from the EUROASPIRE III survey},
  url          = {http://dx.doi.org/10.1177/2047487316667781},
  volume       = {24},
  year         = {2017},
}

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