Psychological interventions halve deaths and cardiovascular events in heart disease patients, according to research from Athens, Greece, presented at the Acute Cardiac Care Congress 2013.
The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC). It takes place 12-14 October in Madrid, Spain.
Dr Zoi Aggelopoulou, a nurse and one of the study authors, said: "The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die, or return to hospital when we talked to them about their treatment, played music for them or helped religious patients to say prayers. It made us think that coronary heart disease is not just physical but also has a psychological component."
She added: "We wanted to find out if others had observed the same thing, and whether psychological support had a real impact on the outcomes of patients with coronary heart disease."
The current study was a meta-analysis of 9 randomised controlled trials. The researchers evaluated whether psychological interventions could improve outcomes of patients with coronary heart disease when combined with a conventional rehabilitation programme.
The researchers found that the addition of psychological interventions reduced mortality and cardiovascular events by 55% after 2 years or more (relative risk [RR]=0.45, 95% confidence interval [CI]=0.37-0.54, p<0.001). The benefits were not significant during the first 2 years (RR=0.77, 95% CI=0.55-1.09, p=0.145).
Dr Aggelopoulou said: "We found a huge benefit of psychological interventions after 2 years, with less patients dying or having a cardiovascular event and therefore fewer repeat hospital visits. The interventions included talking to patients and their families about issues that were worrying them, relaxation exercise, music therapy, and helping them to say prayers."
She added: "Patients want to know what will happen to them when they leave hospital, whether or not they can have sex, and how to take their medication. Our research shows that giving them information and providing reassurance decreases the chances of them dying or having another heart attack. Patients can help instigate this new culture of information by asking more questions and getting more involved in decisions about their treatment."
Population-based studies have shown that psychological factors may have an influence on the likelihood of having a heart attack in the first place. The factors include depression, social isolation, low socioeconomic status, and chronic stress such as occupational or marital distress and stress from caregiving.
Dr Aggelopoulou said: "The results of our study strengthen the evidence that psychological factors have a big role to play in heart disease. Not only do they impact on the risk of having a heart attack, but they also affect the future outlook of a patient who has had a cardiovascular event. This validates our view that cardiovascular disease is not just a physical disease but also has a substantial psychological component."
The researchers concluded that psychological interventions should be incorporated into the rehabilitation of patients with coronary heart disease. Dr Aggelopoulou said: "More clinical trials are needed to clarify which interventions are most effective and how they can best be implemented."
She concluded: "We can help our patients by simply talking to them or introducing new things like music therapy into our clinical practice. Coronary units are busy places – in Greece we sometimes have 1-2 nurses for 10-20 patients in the coronary care unit and we are under time pressure. But our finding that the addition of psychological support on top of physiological therapies reduces death and cardiovascular events by 55% should be a wake-up call that these interventions really do work. Preventing repeat hospital visits would free up the time we need to implement them."
Explore further: Air pollution increases heart attacks
Medical Xpress on facebook
Related Stories
Air pollution increases heart attacks
Oct 07, 2013
Air pollution increases heart attacks, according to research presented at the Acute Cardiac Care Congress 2013 by Dr Savina Nodari from Brescia, Italy. The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute ...
Low BMI is a risk factor for CVD in hypertensive patients with diabetes
Sep 03, 2013
Low BMI is a risk factor for CVD in hypertensive patients with diabetes, according to research presented at the ESC Congress today by Dr Takanori Nagahiro from Japan. The findings provide evidence for an obesity paradox in ...
Coronary angioplasty improves cardiac arrest survival
Oct 20, 2012
Coronary angioplasty improves survival in all patients with out of hospital cardiac arrest, according to research presented at the Acute Cardiac Care Congress 2012. The study was presented by Dr Annamaria Nicolino from the ...
More potent anti-clotting drugs with angiography may benefit patients with acute chest pain
Aug 15, 2013
Current methods to treat acute coronary syndrome conditions, such as heart attack, include artery-clearing procedures (e.g., percutaneous coronary intervention or coronary artery bypass grafting) with medications, or medications ...
Pacemaker for slow heart rhythm restores life expectancy
Sep 02, 2013
Pacemakers implanted for slow heart rhythm restore life expectancy to normal levels, reveals research presented at ESC Congress 2013 today by Dr Erik O. Udo from the Netherlands. The findings provide a new reference point ...
Recommended for you
Disrupting an antioxidant pathway prevents heart disease caused by reductive stress
17 hours ago
University of Utah researchers have found that deficiency of an antioxidant response protein called nuclear erythroid-2 like factor-2 (Nrf2) delays or prevents hypertrophic cardiomyopathy, a type of a heart failure in which ...
Research will 'revolutionize implantable device therapy'
22 hours ago
(Medical Xpress)—Although an irregular heartbeat is a common malady in the United States, affecting an estimated 5 million people, the treatments for it are limited in scope and effectiveness. Now, Igor Efimov, PhD, at ...
Whites more prone to certain heart condition than other ethnic groups
Oct 09, 2013
An individual's race or ethnic background could be a determining factor when it comes to risk of atrial fibrillation, the most frequently diagnosed type of irregular heart rhythm, according to researchers at UC San Francisco.
Running a marathon can be bad for the heart, especially in less prepared runners, say experts
Oct 09, 2013
Investigators who studied a group of recreational marathon runners have established that strenuous exercise such as running a marathon can damage the heart muscle. Although they found the effect is temporary and reversible, ...
Researchers study new heart valve that doesn't require open-heart surgery
Oct 09, 2013
Northwestern's Bluhm Cardiovascular Institute has enrolled its first participant in SALUS, a clinical trial studying the effectiveness of a prosthetic aortic heart valve that can be placed without open-heart surgery. The ...
Amniotic stem cells show promise in helping to repair cardiac birth defects
Oct 09, 2013
Researchers at the University of Michigan Department of Surgery have begun testing an alternative to embryonic stem cells that could one day regenerate muscle tissue for babies with congenital heart defects. A research-in-progress ...
User comments
© Medical Xpress 2011-2013, Phys.org network
Psychological interventions halve deaths and cardiovascular events in heart disease patients, according to research from Athens, Greece, presented at the Acute Cardiac Care Congress 2013.
The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC). It takes place 12-14 October in Madrid, Spain.
Dr Zoi Aggelopoulou, a nurse and one of the study authors, said: "The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die, or return to hospital when we talked to them about their treatment, played music for them or helped religious patients to say prayers. It made us think that coronary heart disease is not just physical but also has a psychological component."
She added: "We wanted to find out if others had observed the same thing, and whether psychological support had a real impact on the outcomes of patients with coronary heart disease."
The current study was a meta-analysis of 9 randomised controlled trials. The researchers evaluated whether psychological interventions could improve outcomes of patients with coronary heart disease when combined with a conventional rehabilitation programme.
The researchers found that the addition of psychological interventions reduced mortality and cardiovascular events by 55% after 2 years or more (relative risk [RR]=0.45, 95% confidence interval [CI]=0.37-0.54, p<0.001). The benefits were not significant during the first 2 years (RR=0.77, 95% CI=0.55-1.09, p=0.145).
Dr Aggelopoulou said: "We found a huge benefit of psychological interventions after 2 years, with less patients dying or having a cardiovascular event and therefore fewer repeat hospital visits. The interventions included talking to patients and their families about issues that were worrying them, relaxation exercise, music therapy, and helping them to say prayers."
She added: "Patients want to know what will happen to them when they leave hospital, whether or not they can have sex, and how to take their medication. Our research shows that giving them information and providing reassurance decreases the chances of them dying or having another heart attack. Patients can help instigate this new culture of information by asking more questions and getting more involved in decisions about their treatment."
Population-based studies have shown that psychological factors may have an influence on the likelihood of having a heart attack in the first place. The factors include depression, social isolation, low socioeconomic status, and chronic stress such as occupational or marital distress and stress from caregiving.
Dr Aggelopoulou said: "The results of our study strengthen the evidence that psychological factors have a big role to play in heart disease. Not only do they impact on the risk of having a heart attack, but they also affect the future outlook of a patient who has had a cardiovascular event. This validates our view that cardiovascular disease is not just a physical disease but also has a substantial psychological component."
The researchers concluded that psychological interventions should be incorporated into the rehabilitation of patients with coronary heart disease. Dr Aggelopoulou said: "More clinical trials are needed to clarify which interventions are most effective and how they can best be implemented."
She concluded: "We can help our patients by simply talking to them or introducing new things like music therapy into our clinical practice. Coronary units are busy places – in Greece we sometimes have 1-2 nurses for 10-20 patients in the coronary care unit and we are under time pressure. But our finding that the addition of psychological support on top of physiological therapies reduces death and cardiovascular events by 55% should be a wake-up call that these interventions really do work. Preventing repeat hospital visits would free up the time we need to implement them."
Explore further: Air pollution increases heart attacks
Medical Xpress on facebook
Related Stories
Air pollution increases heart attacks
Oct 07, 2013
Air pollution increases heart attacks, according to research presented at the Acute Cardiac Care Congress 2013 by Dr Savina Nodari from Brescia, Italy. The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute ...
Low BMI is a risk factor for CVD in hypertensive patients with diabetes
Sep 03, 2013
Low BMI is a risk factor for CVD in hypertensive patients with diabetes, according to research presented at the ESC Congress today by Dr Takanori Nagahiro from Japan. The findings provide evidence for an obesity paradox in ...
Coronary angioplasty improves cardiac arrest survival
Oct 20, 2012
Coronary angioplasty improves survival in all patients with out of hospital cardiac arrest, according to research presented at the Acute Cardiac Care Congress 2012. The study was presented by Dr Annamaria Nicolino from the ...
More potent anti-clotting drugs with angiography may benefit patients with acute chest pain
Aug 15, 2013
Current methods to treat acute coronary syndrome conditions, such as heart attack, include artery-clearing procedures (e.g., percutaneous coronary intervention or coronary artery bypass grafting) with medications, or medications ...
Pacemaker for slow heart rhythm restores life expectancy
Sep 02, 2013
Pacemakers implanted for slow heart rhythm restore life expectancy to normal levels, reveals research presented at ESC Congress 2013 today by Dr Erik O. Udo from the Netherlands. The findings provide a new reference point ...
Recommended for you
Disrupting an antioxidant pathway prevents heart disease caused by reductive stress
17 hours ago
University of Utah researchers have found that deficiency of an antioxidant response protein called nuclear erythroid-2 like factor-2 (Nrf2) delays or prevents hypertrophic cardiomyopathy, a type of a heart failure in which ...
Research will 'revolutionize implantable device therapy'
22 hours ago
(Medical Xpress)—Although an irregular heartbeat is a common malady in the United States, affecting an estimated 5 million people, the treatments for it are limited in scope and effectiveness. Now, Igor Efimov, PhD, at ...
Whites more prone to certain heart condition than other ethnic groups
Oct 09, 2013
An individual's race or ethnic background could be a determining factor when it comes to risk of atrial fibrillation, the most frequently diagnosed type of irregular heart rhythm, according to researchers at UC San Francisco.
Running a marathon can be bad for the heart, especially in less prepared runners, say experts
Oct 09, 2013
Investigators who studied a group of recreational marathon runners have established that strenuous exercise such as running a marathon can damage the heart muscle. Although they found the effect is temporary and reversible, ...
Researchers study new heart valve that doesn't require open-heart surgery
Oct 09, 2013
Northwestern's Bluhm Cardiovascular Institute has enrolled its first participant in SALUS, a clinical trial studying the effectiveness of a prosthetic aortic heart valve that can be placed without open-heart surgery. The ...
Amniotic stem cells show promise in helping to repair cardiac birth defects
Oct 09, 2013
Researchers at the University of Michigan Department of Surgery have begun testing an alternative to embryonic stem cells that could one day regenerate muscle tissue for babies with congenital heart defects. A research-in-progress ...
User comments
© Medical Xpress 2011-2013, Phys.org network
0 comments:
Post a Comment