Way Better Results when Cardiac Rehab Is Combined with Stress Management

Researchers from Duke University Medical Center and the University of North Carolina conducted a study where 151 outpatients with coronary heart disease were randomized to 12 weeks of either Comprehensive Cardiac Rehab (CR) alone or Comprehensive Cardiac Rehab combined with Stress Management Training (CR+SMT).

Biomarkers for stress and coronary heart disease were collected before and after treatment. A matched sample of eligible patients who did not receive CR made up the no-treatment comparison group.

All participants were followed up for up to 5.3 years (median of 3.2 years) for adverse clinical events, i.e., heart attacks.

Outcome measures showed that patients who were randomized to the combined CR+SMT group enjoyed greater reductions in stress levels, as compared to those in the CR alone group (P=0.022). This is thought to be primarily driven by improvements in anxiety, distress, and perceived stress.

Both CR groups achieved significant and comparable, improvements in coronary heart disease biomarkers. Participants in the CR+SMT group exhibited lower rates of clinical events (heart attacks) compared with those in the CR-alone group (18% versus 33%) ; and both CR groups had lower event rates compared with the no-CR group (47%).

The investigators conclude that cardiac rehab, enhanced by stress management training, produces significant reductions in stress and greater improvements in medical outcomes, as compared with standard treatment.

These findings indicate stress management training may provide significant benefit when combined with comprehensive cardiac rehab, and the team recommends that it be incorporated routinely into cardiac rehab programs.

Citation: Blumenthal JA, Sherwood A, Smith PJ, Watkins L, Mabe S, Kraus WE, Ingle K, Miller P, Hinderliter A. Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized, Clinical Efficacy Trial. Circulation. 2016 Apr 5;133 (14):pp. 1341-50. doi: 10.1161/CIRCULATIONAHA.115.018926. Epub 2016 Mar 21.

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