Depressive symptoms decrease health-related quality of life of patients with coronary artery disease and diabetes: a 12-month follow up study in primary care

Figures & data

Figure 1. Flow diagram of the study.

Table 1. Characteristics of the patients at baseline.

	Hypertension (H) N = 244	Coronary artery disease (C) N = 103	Diabetes (D) N = 240	p-value [multiple comparison]**
Women, n (%)	143 (59)	39 (38)	125 (52)	<0.001 [D/H,D/C]
Age, mean (SD)	70 (8)	72 (9)	67 (10)	0.002 [D/H, D/C]
Living with a spouse, n (%)	169 (69)	79 (77)	182 (76)	0.18
Number of educational years, mean (SD)	10.1 (2.9)	10.2 (3.1)	10.2 (3.2)	0.87
Retired, n (%)	215 (88)	94 (91)	208 (87)	0.48
Smoking, n (%)	23 (9)	6 (6)	32 (13)	0.092
Alcohol consumption, n (%)				0.50
Not at all	57 (24)	24 (24)	67 (28)
One time per month or less	77 (32)	37 (36)	74 (31)
2–4 times per month	74 (31)	25 (25)	68 (29)
2–3 times per week	25 (10)	13 (13)	23 (10)
4 or more times per week	9 (4)	3 (3)	6 (3)
Physical activity *, mean (SD)	43 (18)	43 (20)	37 (21)	0.001 [D/H, D/C]
Blood pressure, mmHg, mean (SD)
Systolic	148 (18)	144 (18)	144 (17)	0.027 [D/H]
Diastolic	84 (10)	81 (10)	80 (11)	<0.001 [C/H,D/H]
Body mass index, kg/m^2, mean (SD)	27.9 (4.8)	28.2 (4.9)	31.3 (5.8)	<0.001 [D/H, D/C]
Waist, cm, mean (SD)
Women	94 (14)	96 (15)	105 (15)	<0.001 [D/H, D/C]
Men	103 (11)	101 (11)	109 (13)	<0.001 [D/H, D/C]
HBA1C, mmol/mol, mean (SD)	37.3 (3.9)	38.4 (4.2)	46.0 (10.1)	<0.001 [D/H,D/C]
Fasting plasma glucose, mmol/l, mean (SD)	6.02 (0.57)	6.06 (0.78)	7.36 (1.50)	<0.001 [D/H,D/C]
LDL-C, mmol/l, mean (SD)	3.02 (0.96)	2.24 (0.79)	2.45 (0.90)	<0.001 [D/H,C/H]
Number of diseases, mean (SD)	1.8 (0.9)	2.6 (1.2)	3.1 (1.3)	<0.001 [C/H,D/H,D/C]
Beck depression index score, mean (SD)	5.4 (4.4)	5.7 (4.8)	6.6 (5.5)	0.005 [D/H]
Beck depression index score ≥10, n(%)	32 (13)	16 (16)	45 (19)

*Kasari FIT index, % percentage, n number, SD standart deviation, HbA1c Haemoglobin A1c, LDL-C low-density lipoprotein cholesterol.

**Sidak’s multiple comparison procedure was used to correct significance levels for post hoc testing (p < 0.05).

Table 2. HRQoL was measured with 15D at baseline in hypertension (H), coronary artery disease (C) and diabetes (D) groups.

	Hypertension (H) N = 244	Coronary artery disease (C) N = 103	Diabetes (D) N = 240	p-values*
	Mean (SD)	Mean (SD)	Mean (SD)	Crude	Adjusted**
Mobility	0.908 (0.145)	0.881 (0.163)	0.859 (0.190)	0.005 [D/H]	0.83
Vision	0.948 (0.109)	0.942 (0.111)	0.924 (0.146)	0.11	0.39
Hearing	0.912 (0.151)	0.895 (0.169)	0.905 (0.155)	0.64	0.79
Breathing	0.875 (0.186)	0.799 (0.217)	0.823 (0.213)	0.002 [C/H, D/H]	0.016 [D/C]
Sleeping	0.795 (0.192)	0.787 (0.180)	0.766 (0.215)	0.28	0.40
Eating	0.997 (0.032)	0.983 (0.077)	0.999 (0.023)	0.003 [D/H, D/C]	0.003 [C/H, D/C]
Speech	0.972 (0.087)	0.985 (0.064)	0.979 (0.076)	0.32	0.18
Excretion	0.834 (0.193)	0.817 (0.214)	0.835 (0.211)	0.73	0.30
Usual activities	0.901 (0.162)	0.837 (0.194)	0.862 (0.207)	0.006 [C/H]	0.12
Mental function	0.886 (0.177)	0.906 (0.163)	0.894 (0.168)	0.60	0.081
Discomfort and symptoms	0.704 (0.204)	0.695 (0.179)	0.685 (0.212)	0.61	0.093
Depression	0.922 (0.115)	0.908 (0.152)	0.897 (0.148)	0.14	0.85
Distress	0.907 (0.143)	0.885 (0.145)	0.894 (0.163)	0.39	0.34
Vitality	0.858 (0.146)	0.826 (0.138)	0.816 (0.175)	0.012 [D/H]	0.48
Sexual activity	0.864 (0.226)	0.760 (0.263)	0.778 (0.270)	<0.001 [C/H, D/H]	0.12
Total HRQoL	0.886 (0.083)	0.862 (0.096)	0.863 (0.102)	0.015 [D/H]	0.14

*Sidak’s multiple comparison procedure was used to correct significance levels for post hoc testing (p < 0.05).

**Adjusted for sex, age, BMI, comorbidities, education years and cohabiting.

Figure 2. Change in HRQoL as measured with 15D in hypertension (HA), coronary artery disease (CAD) and diabetes (DM) groups in patients having a baseline BDI score ≥10 and <10. P-values adjusted for sex, age, baseline BMI, number of diseases, education years and cohabiting.

Figure 3. Presents the detailed changes in HRQoL measured with 15D according to BDI score at baseline adjusted for sex, age BMI, number of diseases, education years and cohabiting at the baseline in hypertension (HA), coronary artery disease (CAD) and diabetes (DM) groups.

Figure 4. Relationships of adjusted change in HRQoL (15D) in three different disease groups (hypertension (HA), coronary artery disease (CAD) and diabetes (DM)) as a function of the BDI at baseline. The curves were derived from 3-knot-restricted cubic splines regression models. The models were adjusted for sex, age, baseline BMI, number of diseases, education years and cohabiting. The grey area shows the 95% confidence intervals.

Data availability statement

The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.