Mood instability and cardiovascular modification in cardiovascular disease outpatients. The ABC study on heart disease

Abstract Introduction Mood instability (MI) is a condition characterized by unpredicted frequent fluctuations in a person's emotional state. It is a common personality trait observed in the general population, and it has been reported to be associated with a range of adverse health outcomes, and may also serve as an additional risk factor for cardiovascular morbidity. Purpose To assess mood instability and its effects on cardiovascular function among CVD outpatients. Methods Consecutive patients who were presented to the cardiac outpatient clinic in the last 5 years were recruited and divided into 2 groups according to the presence or absence of MI symptoms based on the patient’s self-assessment psycho-emotion questionnaire. Cardiovascular functions were assessed and compared between both groups. Results A total of 415 patients were included in this preliminary analysis. Patients' mean age was 66±18 years, and 57% were males. Coronary artery diseases were registered in 93(22%) patients. 137 (33%) patients suffered mood instability symptoms, and they shared most demographic and clinical characteristics with patients who did not suffer from MI. However, males were more frequent among patients with no MI symptoms. Interestingly, we observed a significant difference in systolic blood pressure values (SBP) between both groups, (SBP= 150±23 Vs 145±21 mmHg, p= 0.02, for patients with and without MI, respectively). Yet, no difference was observed in diastolic blood pressure (DBP) values (80±12 Vs 79±11 mmHg for patients with and without MI, respectively, p<0.19). Patients with MI symptoms had also a higher heart rate (HR) (77±15 bpm) than patients without symptoms (72±13 bpm, p=0.0003). Using multivariable linear regression models, mood instability (β±SE= 4.3±2.2, p<0.049) and age (β±SE= 0.4±0.05, p<0.0001) were independent predictors for higher SBP values. Mood instability was also independently associated with a higher heart rate (β±SE= 5.1±1.4, p=0.001). Results Kept true even stronger with repeated BP and HR measurements. Conclusion Our results showed that mood instability is associated with a significant increase in systolic blood pressure and heart rate values in cardiac outpatients.