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Psychological interventions for coronary heart disease
1Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, UK, BS8 2PR.
The Cochrane Database of Systematic Reviews
|April 24, 2004
Summary
Psychological interventions, including stress management, did not significantly reduce mortality in coronary heart disease patients. However, they showed modest improvements in reducing anxiety and depression.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- Psychological interventions are part of comprehensive cardiac rehabilitation.
- Stress management interventions aim to reduce stress and cardiac event risk.
Purpose of the Study:
- To evaluate the effectiveness of psychological interventions, particularly stress management, on mortality, morbidity, psychological measures, quality of life, and cardiac risk factors in coronary heart disease (CHD) patients.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) of non-pharmacological psychological interventions in CHD patients.
- Searches conducted across multiple databases up to December 2001.
- Included 36 trials with 12,841 patients; 18 focused on stress management.
Main Results:
- No strong evidence of effect on total or cardiac mortality, or revascularization.
- A potential reduction in non-fatal reinfarctions was observed, but with evidence of publication bias.
- Small reductions in anxiety and depression were noted with psychological interventions.
Conclusions:
- Psychological interventions do not demonstrate efficacy in reducing overall or cardiac mortality in CHD patients.
- Modest reductions in anxiety and depression were observed.
- Poor trial quality, heterogeneity, and publication bias limit the certainty of findings, especially regarding non-fatal myocardial infarction.