Stress-Free Recovery is Better Recovery

New Research Shows Stress Management Could Boost Cardiac Rehabilitation
May 16, 2016

Surviving a heart attack or heart procedure is not the end of the story.

After the damage a heart can endure through the course of heart disease, it needs to heal, and after a heart event or heart surgery, many medical centers recommend a supervised heart rehabilitation program to help in the healing process.

Now new research from UNC School of Medicine and Duke University shows that managing stress is an important part of that healing process.

Diagram of a Heart AttackIn a study published in the journal Circulation, researchers reported that in a population of 151 cardiac patients, adding stress management to cardiac rehab decreased the risk of another cardiac event by more than 50 percent.

Cardiac rehabilitation involves managing risk factors for heart disease like high blood pressure and cholesterol, obesity, diabetes and low physical activity. Doctors help their patients with everything from planning a healthier diet to supervised exercise to medications.

Dr. James Blumenthal, a professor of psychiatry and behavioral sciences at Duke, says that even though stress is commonly thought of as a contributing factor of poor heart health, people don’t always think of stress management as an important key to helping the heart recover.

Some medical centers do incorporate stress management into cardiac rehabilitation, but until now, there was not much hard data to support its importance.

In the Circulation study, 151 people ranging from 36 to 84 years old underwent 12 weeks of cardiac rehabilitation. Half of them engaged in normal cardiac rehab, receiving medication, supervised exercise and dietary counseling. The other half completed those activities, but also went to weekly 90-minute stress management sessions that combined talk-therapy, muscle relaxation and other therapies.

The researchers followed both groups for up to five years (averaging three years). In that follow-up period, 33 percent of the patients who just underwent cardiac rehabilitation experienced a bypass surgery, heart attack, stroke, hospitalization for chest pain or death.

Meanwhile, only 18 percent of those who did weekly stress management in addition to cardiac rehab suffered one of those events. 

The researchers also measured the patients’ stress level using five tests and the stress management group reported significant reductions in anxiety and how much stress they felt they were under.

Stress management or no, the patients who at least did some form of cardiac rehabilitation saw large benefits. Forty-seven percent of patients who did not do cardiac rehab died or had another serious cardiac event.

Cross Section of Heart AttackDoctors and researchers are getting better at treating heart disease, but there is still plenty of work to be done. According to the Centers for Disease Control, 735,000 people in the United States have a heart attack every year, and 210,000 of those are not the patient’s first.

Simple steps like adding cardiac rehabilitation and stress management after a heart attack could be simple ways to drastically cut that 210,000 per year down. Alan Hinderliter, M.D., co-author of the study and a member of the UNC Center for Heart and Vascular Care, says further studies are needed to show that stress management can reduce cardiovascular risk in a broad population, but these results are promising.

Despite the focus on heart recovery, the American Heart Association says it is never to late to start preventing your first cardiovascular event. Quitting smoking, eating a healthier diet, getting more physical activity and knowing the signs of heart attack and stroke are all simple measures that can keep your heart healthy before the first event. You can learn more at their website.

—Daniel Lane

Daniel Lane covers science, medicine, engineering and the environment in North Carolina.