Heart disease, work performance, mental health all connected

Updated 11:45 PM January 7, 2005

Heart disease, work performance, mental health all connected

By Colleen Newvine
News Service

People's perceptions of the severity of their heart illness play an important role in how well they're able to perform at work.

That's one of the notable conclusions of a study by a team of researchers who believe that understanding the effects of a heart attack means not just looking at length of life but also quality of life. The researchers note that perceptions are not necessarily the same as people's physical symptoms.

"People who are convinced they aren't that sick are more likely to be at work and to perform well while they're there," says Dr. Steve Erickson, associate professor of clinical sciences at the College of Pharmacy.

Those who have other illnesses before having a heart episode are less likely to return to work.

In a paper in November's issue of Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy, Erickson and his collaborators look at work-related outcomes of cardiovascular disease. The study examines whether heart disease prevents people from returning to work, and how well they believe they are able to perform on the job.

The study found that those who have other illnesses before having a heart episode are less likely to return to work. "The heart attack becomes the straw that broke the camel's back," Erickson says.

Survey participants who did not return to work had a median of three other illnesses, while those who went back had a median of one other illness besides heart disease.

Work performance is a concern of overall quality of life, Erickson says. Depression commonly occurs in people who have a heart attack, so if a patient gets emotional satisfaction from work, and health problems get in the way of working, his or her emotional state could suffer even more.

In addition, people who are depressed are less likely to make necessary changes in their diet and exercise habits, and are less likely to follow their prescribed medications—leaving them more vulnerable to future heart problems, Erickson says.

Coauthors of the study were Dr. Christopher McBurney, who at the time was a U-M-Pfizer pharmacoeconomics fellow at the School of Public Health; Dr. Kim Eagle, Albion Walter Hewlett Professor of Internal Medicine and clinical director of cardiology; Eva Kline-Rogers, nurse practitioner of cardiology at the U-M Health System; Jeanna Cooper, health science research associate in cardiology; and Dean Smith, statistician with the cardiology department.

Eagle has studied the quality of care for heart disease patients and whether they are getting the appropriate prescriptions, including the so-called Fab Four: aspirin, medications to lower cholesterol, medicines to help reduce the work load of the heart, and medications to lower blood pressure (ACE inhibitors and beta-blockers).

Heart disease, work performance, mental health all connected

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