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Managing stress could reduce heart disease

Managing stress could reduce the risk of recurrent heart attacks and other problems related to heart disease, according to a new report in the Archives of Internal Medicine.

The trial study was led by Mats Gulliksson, M.D., Ph.D., and colleagues at Uppsala University Hospital, Uppsala, Sweden.

"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.

According to the background information in the article, psychosocial factors account for an estimated 30 percent of heart attack risk.

Gulliksson conducted the clinical trial of cognitive behavioral therapy (CBT) among 362 participants who had been discharged from the hospital within the previous 12 months.

A group of 170 patients received traditional care and the rest were asked to participate in CBT.

The cognitive behavioral therapy has five key components with specific goals—education, self-monitoring, skills training, cognitive restructuring and spiritual development—focused on stress management, coping with stress and reducing experience of daily stress, time urgency and hostility, according to the paper.

The results showed patients in the CBT group had a 41 percent lower rate of both fatal and non-fatal heart events, 45 percent lower rate of recurrent heart attacks and 28 percent lower rate of death than the patients in the traditional care group. 

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

To prevent heart disease, Centers for Disease Control and Prevention recommends people should eat a healthy diet, maintain a healthy weight, don’t smoke, limit alcohol use and exercise regularly.

Stephen Lau and editing by Aimee Keenan-Greene