ABSTRACT

Aim: To investigate the impact of cardiovascular risk factors and depressive symptoms on endothelial function in patients undergoing ambulatory cardiac rehabilitation.

Materials and Methods: The study included 98 patients (63 men and 35 women, mean age 49±6 years), who were divided into two groups: Group I – patients with stage I–II arterial hypertension (n=53), and Group II – patients without hypertension (n=45). Endothelial function was assessed using flow-mediated dilation (FMD) of the brachial artery via ultrasound (Samsung H-60, 7 MHz linear probe). The presence and severity of depression were assessed using the HADS scale. All patients completed a structured outpatient cardiac rehabilitation program including aerobic training, psychological support, pharmacological therapy, nutritional counseling, and educational sessions.

Results: Patients with hypertension (Group I) demonstrated significantly lower endothelium-dependent and endothelium-independent vasodilation compared to Group II (p<0.05). Clinically significant depression was observed in 35% of hypertensive patients at baseline and in 11% of patients in Group II. After rehabilitation, no cases of clinically significant depression were observed in either group, with affected patients shifting to the subclinical depression category. No statistically significant correlation was found between the severity of depressive symptoms and endothelial function parameters.

Conclusions: The presence of hypertension is associated with impaired endothelial function and a higher prevalence of depressive symptoms. A comprehensive outpatient cardiac rehabilitation program, integrating physical, psychological, pharmacological, nutritional, and educational interventions, contributed to a significant reduction in depressive symptoms and improvement in patients’ psychoemotional status. These findings support the inclusion of psychosocial interventions in routine cardiovascular care.

KEYWORDS: cardiac rehabilitation; endothelial dysfunction; arterial hypertension; depression; cardiovascular risk factors