Association between mental health and physical activity in patients with chronic heart failure

Purpose: Poor mental health (MH) is common in chronic heart failure (CHF) patients. No studies have reported a relation between MH status and objectively measured physical activity (PA) in CHF patients. The study aim was to determine self-reported MH-related differences associated with PA and target values of PA for improved MH in CHF outpatients. Methods: We divided 243 CHF outpatients (mean age 57.1 years) into two groups according to MH assessed by Short Form-36 score: high-MH (≥68 points) group (n=148) and poor-MH (<68 points) group (n=95). Average step count (steps) and energy expenditure on PA (EE) (kcal) per day for 1 week of PA were assessed by an accelerometer and compared between groups. PA resulting in high MH was determined by the receiver-operating characteristic (ROC) analysis. Results: PA correlated positively with MH in all patients (steps: r=0.46, p<0.001; EE: r=0.43, p<0.001). After adjusting for patient characteristics, steps and EE were significantly lower in the poor-MH versus high-MH group (5020.1±280.7 versus 7174.1±221.5 steps, p<0.001; 133.9±10.8 versus 215.9±8.4kcal, p<0.001). Cut-off values of 5590.8 steps and 141.1kcal were determined as PA target values associated with improved MH. Conclusions: Poor MH status may reduce PA. Attaining PA target values may improve MH status of CHF outpatients.Implications for RehabilitationPoor mental health may negatively affect physical exercise in CHF outpatients.In particular step counts and energy expenditure are lower in those with poor mental health.It may be that focused exercise training may impact positively both on mental health and physical well being.