Background: Globally, coronary artery disease (CAD) is a major cause of illness and death. Health-related quality of life (HRQoL) is becoming increasingly acknowledged as a crucial component of patient care, even though clinical management has improved results.Objectives: To determine and assess the main factors – such as behavioural, psychological, clinical, and sociodemographic ones – that affect HRQoL in patients with CAD.Methods: Three tertiary hospitals’ worth of 300 CAD patients participated in a cross-sectional study. Using the SF-36 questionnaire, HRQoL was assessed. Age, gender, income, educational attainment, smoking status, physical activity, comorbidities, and psychological distress (as assessed by the HADS) were all considered independent variables. To identify independent determinants of HRQoL, multivariate linear regression was used.Results: Age (β = –0.32, p < 0.01), depression scores (β = –0.45, p < 0.001), physical activity (β = 0.29, p < 0.01), and diabetes presence (β = –0.24, p = 0.03) were also significant predictors of HRQoL. There were also somewhat positive correlations between income and education. 58% of the variation in HRQoL was explained by the model (adjusted R2 = 0.58).Conclusion: Comorbidities, lifestyle choices, and psychological state – all have a big influence on HRQoL in CAD patients. By addressing these factors, holistic treatment may improve patient outcomes and well-being.

Keywords: Coronary artery disease (CAD), health-related quality of life (HRQoL), psychological distress, physical activity, comorbidities

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1. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83. PMID: 1593914.
2. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res. 2002;52(2):69–77.
3. Lichtman JH, et al. Depression and coronary heart disease. Circulation. 2008;118(17):1768–75.
4. World Health Organization. Diseases Progress Monitor 2020. Geneva: WHO; 2020 [cited 2025 Oct 15]. Available from: https://www.who.int/publications/i/item/ncd-progress-monitor-2020
5. Lavie CJ, Arena R, et al. Exercise and the cardiovascular system: Clinical science and cardiovascular outcomes. Circ Res. 2015;117(2):207–19.
6. Kandasamy G, Subramani T, Almanasef M, Orayj K, Shorog E, Alshahrani AM, et al. Exploring factors affecting health-related quality of life in coronary artery disease patients. Medicina (Kaunas). 2025;61(5):824. doi:10.3390/medicina61050824. PMID: 40428782; PMCID: PMC12113040.
7. Jlassi O, Omrane A, Ben Massoud M, Khalfallah T, Bouzgarrou L, Gamra H. Determinants of health-related quality of life among patients with ischemic heart disease. Health Syst (Basingstoke). 2023;13(4):322–31. doi:10.1080/20476965.2023.2275799. PMID: 39839496; PMCID: PMC11750061.
8. Eshah NF. Jordanian acute coronary syndrome patients’ learning needs: implications for cardiac rehabilitation and secondary prevention programs. Nurs Health Sci. 2011;13(3):238–45. doi:10.1111/j.1442-2018.2011.00608.x. PMID: 21615656.
9. Abreu A, Mendes M, Dores H, Silveira C, Fontes P, Teixeira M, et al. Mandatory criteria for cardiac rehabilitation programs: 2018 guidelines from the Portuguese Society of Cardiology. Rev Port Cardiol (Engl Ed). 2018;37(5):363–73. doi:10.1016/j.repc.2018.02.006. PMID: 29724635.

Background: Globally, coronary artery disease (CAD) is a major cause of illness and death. Health-related quality of life (HRQoL) is becoming increasingly acknowledged as a crucial component of patient care, even though clinical management has improved results.Objectives: To determine and assess the main factors – such as behavioural, psychological, clinical, and sociodemographic ones – that affect HRQoL in patients with CAD.Methods: Three tertiary hospitals’ worth of 300 CAD patients participated in a cross-sectional study. Using the SF-36 questionnaire, HRQoL was assessed. Age, gender, income, educational attainment, smoking status, physical activity, comorbidities, and psychological distress (as assessed by the HADS) were all considered independent variables. To identify independent determinants of HRQoL, multivariate linear regression was used.Results: Age (β = –0.32, p < 0.01), depression scores (β = –0.45, p < 0.001), physical activity (β = 0.29, p < 0.01), and diabetes presence (β = –0.24, p = 0.03) were also significant predictors of HRQoL. There were also somewhat positive correlations between income and education. 58% of the variation in HRQoL was explained by the model (adjusted R2 = 0.58).Conclusion: Comorbidities, lifestyle choices, and psychological state – all have a big influence on HRQoL in CAD patients. By addressing these factors, holistic treatment may improve patient outcomes and well-being.

Keywords: Coronary artery disease (CAD), health-related quality of life (HRQoL), psychological distress, physical activity, comorbidities

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83. PMID: 1593914.
2. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res. 2002;52(2):69–77.
3. Lichtman JH, et al. Depression and coronary heart disease. Circulation. 2008;118(17):1768–75.
4. World Health Organization. Diseases Progress Monitor 2020. Geneva: WHO; 2020 [cited 2025 Oct 15]. Available from: https://www.who.int/publications/i/item/ncd-progress-monitor-2020
5. Lavie CJ, Arena R, et al. Exercise and the cardiovascular system: Clinical science and cardiovascular outcomes. Circ Res. 2015;117(2):207–19.
6. Kandasamy G, Subramani T, Almanasef M, Orayj K, Shorog E, Alshahrani AM, et al. Exploring factors affecting health-related quality of life in coronary artery disease patients. Medicina (Kaunas). 2025;61(5):824. doi:10.3390/medicina61050824. PMID: 40428782; PMCID: PMC12113040.
7. Jlassi O, Omrane A, Ben Massoud M, Khalfallah T, Bouzgarrou L, Gamra H. Determinants of health-related quality of life among patients with ischemic heart disease. Health Syst (Basingstoke). 2023;13(4):322–31. doi:10.1080/20476965.2023.2275799. PMID: 39839496; PMCID: PMC11750061.
8. Eshah NF. Jordanian acute coronary syndrome patients’ learning needs: implications for cardiac rehabilitation and secondary prevention programs. Nurs Health Sci. 2011;13(3):238–45. doi:10.1111/j.1442-2018.2011.00608.x. PMID: 21615656.
9. Abreu A, Mendes M, Dores H, Silveira C, Fontes P, Teixeira M, et al. Mandatory criteria for cardiac rehabilitation programs: 2018 guidelines from the Portuguese Society of Cardiology. Rev Port Cardiol (Engl Ed). 2018;37(5):363–73. doi:10.1016/j.repc.2018.02.006. PMID: 29724635.