Background:
Obesity has been associated with symptoms of depression and is negatively associated with measures of cardiovascular health. Yet, the impact of depressive symptoms in obese patients with coronary heart disease on cardiac rehabilitation (CR) completion rates and clinical outcomes has not been fully investigated.
Objectives:
The goal of this study was to determine the effects of depressive symptoms in obese (BMI >= 30) patients on CR program completion rates and clinical outcomes, including changes in total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), and body mass index (BMI).
Methods:
In a retrospective analysis, we evaluated the effects of depression, as characterized by the Beck Depression Inventory (BDI-II) in obese patients on CR completion in a sample of 558 consecutive patients ([female sign] = 156, [male sign] = 402) entering a CR program from 1/10/03-3/12/04. In addition, in the 384 patients who completed CR, we evaluated whether depressive symptoms (BDI >= 14) in obese patients affected whether patients achieved improved CR clinical outcomes.
Results:
Obese patients with enrollment BDI >= 14 compared to obese patients with BDI < 14 had significantly higher rates of CR non-completion (58% vs. 42% P = 0.004, respectively). Obese patients with BDI >= 14 who successfully completed CR achieved statistically significant improvements in clinical variables comparable to obese patients with BDI < 14.
Conclusion:
Obese individuals with BDI >= 14 are at risk for CR non-completion and should be encouraged and supported to complete CR as cardiovascular benefits comparable to obese individuals with low BDI scores were achieved when these patients completed the program.