Perceived Social Support, Heart Rate Variability, and Hopelessness in Patients with Heart Disease

Hopelessness is present in up 52% of patients with ischemic heart disease (IHD) and associated with increased morbidity and mortality. Decreased perceived social support (PSS) has been associated with increased hopelessness in patients with IHD reporting moderate to severe hopelessness but has not been examined in a well-powered sample reporting varying levels of hopelessness. Increased PSS is associated with increased high frequency (HF) and RMSSD heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients following an IHD event. Purpose: The purpose of this dissertation was to examine the relationships among PSS, HRV, and hopelessness in patients following an acute IHD event. Methods: Utilizing a cross-sectional design, 178 participants were enrolled while hospitalized for an IHD event at one large hospital in the United States. Data collection occurred two weeks after hospital discharge using the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, and a short-term HRV measurement. Results: There was a moderate inverse correlation between PSS and state (r = 0.31, p < 0.001) and trait (r = 0.28, p < 0.001) hopelessness in unadjusted models. The relationships remained significant in adjusted models and did not differ between groups comparing sex, type of IHD event, and marital status. There was a moderate inverse correlation between HF HRV and state hopelessness (r = 0.24, p = 0.023), and RMSSD HRV and state hopelessness (r = 0.24, p = 0.021). These results remained significant in adjusted models and did not differ between groups comparing sex, type of IHD event, beta-blocker prescription, and time of day that HRV was recorded. HF and RMSSD HRV did not mediate the relationship between PSS and hopelessness. Conclusions: There were significant inverse associations between PSS and state and trait hopelessness, HF HRV and state hopelessness, and RMSSD and state hopelessness. Persons with low PSS and/or low HRV may be at greater risk for experiencing hopelessness following an IHD event. Future research should consider designing well-powered randomized controlled trials to test interventions to reduce hopelessness in diverse samples of patients with IHD.