Women With PAD Also Have More Depressive Symptoms

Women diagnosed with peripheral artery disease (PAD) also have a high burden of depressive symptoms, a new study suggests.

“The association of depressive symptoms with health status in PAD is understudied,” the authors wrote. “No reports of differential impact on women have been described.”

The PORTRAIT (Patient‐Centered Outcomes Related to Treatment Practices in Peripheral Artery Disease Investigating Trajectories) registry included 1,243 patients with new or worsening PAD symptoms. Researchers assessed depressive symptoms via the 8-Item Patient Health Questionnaire. A score of 10 or higher was indicative of clinically relevant depressive symptoms. They also assessed disease-specific and generic health status (at baseline, three, six, and 12 months) using the Peripheral Artery Questionnaire and EQ-5D Visual Analogue Scale. They then constructed an adjusted general linear model for repeated measures for baseline, three-, six-, and 12-month health status outcomes by depressive symptoms assessed at baseline.

According to the results, more women than men (21.1% vs. 12.9%; P<0.001) had severe depressive symptoms. The adjusted model revealed that patients with depressive symptoms had worse health status at every time point (P<0.0001 for all), with similar results seen for the EQ-5D Visual Analogue Scale Scores. Depressive symptoms explained 19% of the association between sex differences in the 1-year Peripheral Artery Questionnaire summary scores, the authors wrote. Sex differences were not observed for the magnitude in 1-year change in health status scores.

“A major goal of PAD treatment is improving patients’ health status and quality of life,” study author Qurat-Ul-Ain Jelani, MD, an interventional cardiologist in training at Yale University School of Medicine, said in a press release. “Not recognizing or treating depressive symptoms may stand in the way of realizing optimal recovery. As more value-based care options are designed for patients with PAD, integrating mental health screening and treatment pathways into chronic disease management may increase the opportunity for patients to receive more holistic care, thus improving outcomes. A multidisciplinary approach that includes mental health supports for patients with PAD would be beneficial.”

The study was published in the Journal of the American Heart Association.