Suicidal ideation in coronary heart disease patients: the role of ethnicity and lifestyle factors

BACKGROUND: Suicidal ideation (SI) is more prevalent in people with coronary heart disease (CHD) when compared to the general population. However, studies on protective factors against SI in people with cardiovascular diseases are still lacking. Moreover, there is less known about risk factors, such as ethnicity or lifestyle factors in SI and suicidal behavior. Thus, we aimed to examine the associations between ethnicity, lifestyle factors and SI in people with CHD when controlled for sociodemographic and clinical variables. METHODS: We included 878 patients (60.0% male; 86.0% non-Roma; mean age 57.81±7.59 years; BMI 29.78±10.39 kg/m2) with CHD. All participants completed the 36-Item Short Form Survey, Food Frequency Questionnaire, Physical Activity Scale, and the General Health Questionnaire-28. Correlation analyses and multiple linear regressions were used to analyze the data. RESULTS: The prevalence of SI was higher in Roma people with CHD (12%) when compared to non-Roma (2.9%). Bivariate analyses showed significant associations between lower age, Roma ethnicity, lower education, lower income, poor mental health, consumption of smoked food, low consumption of fruit and vegetables, smoking, physical inactivity and SI. No association between functional status, physical quality of life and SI was identified. Multivariate analyses showed that lower age (β=-.06; p<.05), poor mental health (β=-.39; p<.001), smoking (β=.09; p<.05), and physical inactivity (β=.10; p<.01) were associated with higher SI in CHD, with an explained variance of 21.0% in SI. CONCLUSIONS: A better quality diet and physical activity may have a positive effect on diminishing SI in CHD. A thorough understanding of the protective lifestyle factors, including physical activity, dietary habits, and being a non-smoker could facilitate the development of tailored intervention programs to improve mental health in people with CHD (Grant support: VEGA: 1/0748/22) KEY MESSAGES: • Interventions aimed at a healthy lifestyle may diminish the psychological burden in CHD patients. • Ethnic disparities in mental health should be considered when designing public health interventions.