Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 20;77(1):64.
doi: 10.1186/s43044-025-00658-8.

Impact of cardiac rehabilitation on anxiety, depression, and health-related quality of life in cardiovascular patients

Estrella García-Sánchez  1 , Mirian Santamaría-Peláez  2 , Jerónimo J González-Bernal  3 , Josefa González-Santos  3 , María Azucena Sedano García  1 , Inmaculada De Juana Velasco  1 , Jesús Sánchez Hernández  1 , Héctor García Pardo  4 , Jessica Fernández-Solana  3
Affiliations

Impact of cardiac rehabilitation on anxiety, depression, and health-related quality of life in cardiovascular patients

Estrella García-Sánchez et al. Egypt Heart J. .

Abstract

Introduction: The study aimed to evaluate the effects of a cardiac rehabilitation program based on physical exercise and the promotion of healthy habits on anxiety, depression, and health-related quality of life in patients with cardiovascular conditions. Additionally, it sought to analyze the influence of baseline anxiety and depression levels on post-treatment health-related quality of life outcomes.

Methods: A longitudinal study was conducted with 189 patients who completed a structured cardiac rehabilitation program. Anxiety and depression were assessed using the Goldberg Anxiety and Depression Scale, while health-related quality of life was measured with the RAND-36 survey. Data were collected pre- and post-intervention. Statistical analyses included paired t tests for pre/post-comparisons and ANCOVA to evaluate the impact of initial anxiety and depression on health-related quality of life improvements.

Results: The cardiac rehabilitation program significantly reduced anxiety (mean difference = - 0.93, CI: - 1.42 to - 0.44, p < 0.001; Cohen's d = 0.35) and depression (mean difference = - 0.62, CI: - 0.99 to - 0.25, p < 0.001; Cohen's d = 0.32), with improvements observed across several health-related quality of life dimensions, including emotional well-being (p = 0.005) and energy/fatigue (p < 0.001). Baseline anxiety and depression levels influenced changes in specific health-related quality of life dimensions, such as social functioning and role limitations due to physical health (p < 0.05). Causal interpretations are limited by the observational design and absence of a control group.

Discussion: The results show an association between participation in cardiac rehabilitation programs and a reduction in anxiety and depression, as well as improved health-related quality of life in patients with cardiovascular disease. Baseline psychological status plays a key role in determining the magnitude of health-related quality of life improvements, highlighting the need for tailored interventions.

Keywords: Anxiety; Cardiac rehabilitation; Cardiovascular disease; Depression; Quality of life.

PubMed Disclaimer

Conflict of interest statement

Declarations. Human ethics: The study was conducted in accordance with the Declaration of Helsinki and approved by the Medicines Research Ethics Committee of the Burgos and Soria Health Area (Ref. CEIm 2569) for studies involving humans. Consent to participate: Informed consent was obtained from all subjects involved in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, Lin G, Lindenfeld J, O’Connor C, Panjrath G (2021) Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am Coll Cardiol 77(11):1454–1469 - PubMed
    1. Brown TM, Pack QR, Aberegg E, Brewer LC, Ford YR, Forman DE, Gathright EC, Khadanga S, Ozemek C, Thomas RJ (2024) Core components of cardiac rehabilitation programs: 2024 update: a scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 150(18):e328–e347 - PubMed
    1. Child A, Sanders J, Sigel P, Hunter MS (2010) Meeting the psychological needs of cardiac patients: an integrated stepped-care approach within a cardiac rehabilitation setting. Br J Cardiol 17(4):175–179
    1. Patel DK, Duncan MS, Shah AS, Lindman BR, Greevy RA Jr, Savage PD, Whooley MA, Matheny ME, Freiberg MS, Bachmann JM (2019) Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery. JAMA Cardiol 4(12):1250–1259. 10.1001/jamacardio.2019.4032 - PMC - PubMed
    1. Taylor RS, Dalal HM, McDonagh STJ (2022) The role of cardiac rehabilitation in improving cardiovascular outcomes. Nat Rev Cardiol 19(3):180–194 - PMC - PubMed

LinkOut - more resources