Characteristics of people aged 45 years or older with heart disease by frequent mental distress status, 2001

Background. Depression commonly occurs after nonfatal cardiac events and is associated with adverse health outcomes. Methods. In 2001, the Behavioral Risk Factor Surveillance System, an ongoing, state-based, random-digit-dialed telephone survey of non-institutionalized adults, administered cardiovascular health questions to 19 states and DC. Among those aged ≥45 years, we examined the association of frequent mental distress (FMD) (≥14 self-reported mentally unhealthy days in the past 30 days) with modifiable adverse behaviors (smoking, physical inactivity, and obesity) and health care coverage. Results. The prevalence of FMD among adults with heart disease was 14.8%. Age-adjusted odds ratios indicated that adults with heart disease and FMD were more likely to smoke, to be physically inactive, to be obese, and to be without health care coverage than persons without FMD. Although frequent mental distress was associated with only one adverse health behavior (physical inactivity) after fully adjusting when these health behaviors were considered separately, we observed a twofold increased likelihood for the presence of multiple adverse health behaviors among those with FMD as compared to those without FMD. Conclusions. Medical counseling on lifestyle changes after cardiac events is accepted as a key part of rehabilitation; however, the mental well-being of patients may also need to be monitored, as it may be a mediating factor in achieving healthy lifestyle goals.