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Health & Medicine for Senior Citizens

Stress Therapy Prevents Repeat Heart Attacks, Saves Lives of Heart Patients

Those in program had 41% fewer fatal and non-fatal heart events and a 28% lower death rate

Jan. 24, 2011 - A cognitive behavioral therapy program focusing on stress management appears to decrease the risk of recurrent heart attacks by 45 percent and other cardiovascular events in patients with heart disease, according to a report in the January 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Psychological and social factors account for an estimated 30 percent of heart attack risk, according to background information in the article.

Psychosocial factors that may promote atherosclerosis and cardiovascular disease belong to two general categories:
   ● chronic stressors, including low socioeconomic status, low social support, marital distress and work distress; and
   ● emotional factors, including major depression, hostility, anger and anxiety," the authors write.


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These issues are believed to contribute to the risk of heart disease even after adjusting for the effects of traditional risk factors.

A randomized controlled clinical trial of cognitive behavioral therapy (CBT) among 362 men and women discharged from the hospital after a coronary heart disease event within the previous 12 months was conducted by Mats Gulliksson, M.D., Ph.D., and colleagues at Uppsala University Hospital, Uppsala, Sweden.

A group of 192 patients were randomly assigned to participate in CBT.

"The program has five key components with specific goals - education, self-monitoring, skills training, cognitive restructuring and spiritual development - and is focused on stress management, coping with stress and reducing experience of daily stress, time urgency and hostility," the authors write.

Therapy was delivered in 20 two-hour sessions during one year, in small groups separated by sex. The other 170 patients received traditional care.

There was a follow-up with participants that averaged 94 months.

Results for the CBT group were:
   ● 23 participants died,
   ● 69 (35.9 percent) had a non-fatal cardiovascular event and
   ● 41 (21.4 percent) had a non-fatal heart attack.

This compares to the traditional care group results:
   ● 25 deaths,
   ● 77
(45.3 percent) non-fatal cardiovascular events and
   ● 51
(30 percent) non-fatal heart attacks.

Patients in the CBT group had a 41 percent lower rate of both fatal and non-fatal heart events, 45 percent fewer recurrent heart attacks and a non-significantly lower rate of death (28 percent) than patients in the traditional care group. Attending a higher proportion of the therapy sessions was associated with a further reduction in risk.

"These results imply that, to affect cardiovascular disease or coronary heart disease end points, the interventions need to be long-term (possibly six to 12 months), be conducted in groups and include specific techniques for altering behavior," the authors write.

"A possible mechanism is decreased behavioral and emotional reactivity, which would lead to less psychophysiologic burden on the cardiovascular system."

The findings represent not only statistical significance but also clinical importance, the authors note.

"This demonstrates the potential efficacy of adding CBT to secondary preventive programs after acute myocardial infarction (heart attack) for better patient adherence to treatment and better outcome," they conclude.

Books for Senior Citizens

New Book Targets Better Nutrition for Heart Attack Survivors: Prevent a Second Heart Attack

Janet BrillAuthor Janet Bond Brill inspired after her father dies from second heart attack; focus is on 8 foods, includes recipes

Jan. 12, 2011 - Each year, roughly 1.5 million Americans have a heart attack -- and most of them survive. But research shows that just one year after their diagnosis, the vast majority of these 13 million American heart attack survivors fail to adhere to the dietary changes that could prevent a second heart attack. Read more...


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