Emotional symptoms and quality of life in patients with pulmonary arterial hypertension

J Heart Lung Transplant. 2014 Aug;33(8):800-8. doi: 10.1016/j.healun.2014.04.003. Epub 2014 Apr 19.


Background: Limited evidence exists on the nature and degree of emotional problems in pulmonary arterial hypertension (PAH) and their association with patients' health-related quality of life (HRQOL).

Methods: This cross-sectional study examined the presence of depression, anxiety, and stress symptoms, and their association with disease-specific and generic HRQOL. A total of 101 patients (73% women) with PAH (age, 55.4 ± 16.4 years; 42.6% in New York Heart Association [NYHA] class II) completed the Depression, Anxiety, and Stress Scale, the generic Medical Outcomes Study Short-Form 36-Item (SF-36) Health Survey, and the disease-specific Minnesota Living With Heart Failure Questionnaire (MLHFQ) HRQOL instrument. The association between emotional problems and HRQOL was determined using multivariable linear regression analyses, controlling for demographic and disease-related characteristics.

Results: Of the patients, 32.6%, 48%, and 27.6% experienced depressive, anxiety or stress symptoms, respectively. HRQOL was >1 standard deviation below population norms for the SF-36 Physical Component Summary. Depressive symptoms, NYHA class, and being disabled explained 46% of the total variance of the MLHFQ. Emotional problems did not contribute to the SF-36 Physical Component Summary but explained part of the variance of the physical sub-scales of the SF-36 role limitations due to physical problems, bodily pain, and general health.

Conclusions: The high presence of emotional problems warrants regular screening and appropriate psychotherapeutic and/or pharmacological treatment. Which strategies could improve PAH patients' HRQOL remains to be investigated.

Keywords: Pulmonary arterial hypertension; mood problems; psychological functioning; quality of life.

MeSH terms

  • Adult
  • Aged
  • Anxiety / epidemiology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Emotions / physiology*
  • Female
  • Health Surveys
  • Humans
  • Hypertension, Pulmonary / physiopathology*
  • Hypertension, Pulmonary / psychology*
  • Linear Models
  • Male
  • Middle Aged
  • Prevalence
  • Quality of Life / psychology*
  • Stress, Psychological / epidemiology