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ind Body Health
 

Reducing Stress Reduces Heart Disease

© David S. Sobel MD

The following is one in an ongoing series of columns entitled Mind Body Health by David S. Sobel MD. View all columns in series
The usual routine for patients with heart disease is to lower cholesterol and blood pressure, stop smoking, encourage exercise, give various heart medications, and sometimes angioplasty or bypass surgery. But doctors may soon add stress management and relaxation to their attack on heart disease.

A new study of patients with heart disease found that relaxation, taming hostility, and helping people change the way they look at life's challenges can reduce their risk of having further heart problems by 75% compared to people given only usual medical care and medications. Reducing stress proved even more beneficial than getting exercise.

In this study, 107 heart patients were randomly divided into three groups. The control group of forty patients received usual medical care. Another 34 engaged in a vigorous exercise program for 35 minutes three times a week for 16 weeks in addition to their usual medical care. And 33 patients along with their usual care from physicians also participated in a stress management program that included: Weekly group sessions, educational information on heart disease and stress, and muscle relaxation practice and biofeedback. Patients were taught skills to monitor automatic irrational thought patterns and to develop alternative interpretations of situations and thought patterns. They were also instructed how to recognize signs of stress and manage moods such as anger and depression.

The patients' medical records were tracked for the next two to five years for heart attacks, bypass surgery, and angioplasty. In the control group that received standard medical care, 30% had additional heart trouble compared to 21% in the exercise group (not significantly different from usual care). But the stress management group showed a dramatic difference-- only 10% had further heart problems. This translates into roughly one-quarter the cardiac risk compared to those not receiving the additional psychological skill training. The stress management training also resulted in lower levels of psychological distress, less hostility, and fewer episodes of ischemic chest pain. If a new drug produced the same 75% reduction in cardiac risk as stress management, it would be headlines and rapidly prescribed by physicians. Until this becomes standard of care, patients may have to seek out their own opportunities to learn stress management as part of their treatment.

For More Information
Blumenthal JA, et al: Stress Management and Exercise Training in Cardiac Patients with Myocardial Ischemia: Effects on Prognosis and Evaluation of Mechanisms. Archives of Internal Medicine 1997;157:2213-2223


Excerpted with permission from the Quarterly Newsletter, Mind/Body Health Newsletter. For subscription information call 1-(800)-222-4745 or visit the Institute for the Study of Human Knowledge website.

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About The Author
David S. Sobel, M.D., M.P.H., is a practicing physician in adult medicine and Medical Director of Patient Education and Health Promotion for Kaiser Permanente Northern California. He is physician lead for the national initiative in Self-Care and Shared Decision-Making for Kaiser Permanente. He is coauthor of Living a Healthy Life with Chronic Conditions, The Healing Brain,......more
 
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