Talk It Out to Cut Cardiovascular Event Risk

Cognitive-behavioral therapy shown to curb risk of second cardiovascular event

(RxWiki News) Learning to manage stress better through cognitive-behavioral therapy (CBT) helps patients with heart disease lower their risk of recurrent heart attacks, according to a new study.

Psychosocial factors such as chronic stressors (e.g., low socioeconomic status, low social support, marital distress and work distress) and emotional factors (e.g., major depression, hostility, anger and anxiety) account for an estimated 30 percent of heart attacks by promoting atherosclerosis (hardening of the arteries) and cardiovascular disease.

Researchers at Uppsala University Hospital, Uppsala, Sweden, conducted a randomized, controlled cognitive-behavioral therapy clinical trial of 362 patients who had experienced a coronary heart disease event within the previous 12 months. The program addressed five major areas (education, self-monitoring, skills training, cognitive restructuring and spiritual development) with a focus on stress management delivered via 20 two-hour sessions in small groups among 192 patients. The remaining 170 patients in the control group received traditional medical care.

After 94 months of follow-up, on average, a total of 23 patients in the cognitive-behavioral therapy group died; 69 experienced a non-fatal cardiovascular event; and 41 experienced a non-fatal heart attack. Comparatively, in the control group, 25 patients died; 77 experienced non-fatal cardiovascular events; and 51 experienced non-fatal heart attacks.

In order for cognitive-behavioral therapy approaches to be effective, the study authors said the interventions should be long-term (at least six to 12 months), be conducted in groups and include information about altering behavior.

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Review Date: 
January 25, 2011