Question: What kinds of stress reduction techniques work best for cardiac patients?
Answer: We don't have the kind of clinical trials with stress reduction techniques for cardiac patients that we do for drugs like the statins, beta blockers, aspirin, those sorts of things. What we do have is evidence that training people with heart disease in coping skills, and coping skills that can help them to identify those situations that are stressful for them when they're experiencing the stress, so they can evaluate their reaction to that situation and make a rational decision -- whether they need to do something to change the stressor or they need to do something to change that reaction, that frustration, that anger, that adrenaline that they're doing, and not engage in those unhealthy behaviors.
If people can learn to use these kinds of skills to manage stress better, there is evidence from randomized, controlled trials in heart patients, that anxiety levels go down, depression levels go down, social support levels go up, perceived stress levels go down. All of these are subjective reports that people give after the training in these coping skills.
But you can't fake your blood pressure. And these same randomized trials showed that people getting this kind of coping skills training -- patients who have heart disease -- show a decrease in not only their resting blood pressure and heart rate, but also the amount of rise in blood pressure and heart rate when they are stressed in a laboratory mental stress situation.
So there's reason to believe that these kinds of coping skills -- if mastered by people with heart disease -- at least do have the potential to improve the prognosis and to make them more resistant to stress. What we need now, given these encouraging early studies, are larger studies that will document that, in addition to reducing your depression and your blood pressure and your blood pressure reaction to stress, that they also improve your prognosis. And that's the work that needs to be done now.
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