Secrets To Heart Health: Aerobic Exercise and Stress Management Training
exercise and stress management training can reduce levels of depression
and emotional distress, as well as improve markers of cardiovascular
risk in patients with heart disease, according to a study in the April
6, 2005 issue of JAMA.
heart disease (IHD) is the leading cause of death in the United States
and is rapidly becoming the leading cause of death in developing
countries around the world, according to background information in the
factors are now recognized as playing a significant and independent
role in the development of IHD and its complications. Consequently,
efforts to alter psychosocial riskfactors, particularly in the setting
of cardiac rehabilitation, have received increased attention. However,
the effects of behavioral interventions to reduce adverse cardiac
events has been uncertain.
Blumenthal, Ph.D., of Duke University Medical Center, Durham, N.C., and
colleagues compared the impact of two behavioral intervention programs,
aerobic exercise and stress management training, with routine medical
care on psychosocial functioning and select markers of cardiovascular
risk. The randomized controlled trial included 134 patients (92 male
and 42 female; aged 40-84 years) with stable IHD and exercise-induced
myocardial ischemia (decreased blood supply to the heart muscle). The
trial was conducted from January 1999 to February 2003.
received either routine medical care (usual care); usual care plus
supervised aerobic exercise training for 35 minutes 3 times per week
for 16 weeks; or usual care plus weekly 1.5-hour stress management
training for 16 weeks.
researchers found that patients in the exercise and stress management
training groups exhibited lower average depression scores and reduced
distress scores compared with patients receiving usual care only.
Exercise and stress management training were also associated with
favorable improvements in certain cardiovascular risk markers, compared
with usual care patients.
this randomized controlled trial demonstrate that behavioral treatments
provide added benefits to routine medical management in patients with
stable IHD," the authors write.
authors add that "caution should be exercised in interpreting the
clinical significance of improvements in intermediate end points. In
the absence of clinical standards for these measures, the clinical
significance of these changes is uncertain. Ultimately, the long-term
effects of exercise training or stress management will need to be
evaluated prospectively in a larger sample of patients with IHD."
present study provides insight into potential mechanisms by which
exercise or stress management training may be of benefit. Our results
suggest that exercise and stress management training offer considerable
promise to patients with stable IHD through improvement in psychosocial
adjustment and by modification of disease risk markers that may
translate into improved clinical outcomes."
Editor's Note: This study was supported by grants from the National Institutes of Health.