Author: Nijjar PS1, Connett JE2,3, Lindquist R4, Brown R2, Burt M5, Pergolski A5, Wolfe A6, Balaji P6, Chandiramani N6, Yu X6, Kreitzer MJ7, Everson-Rose SA6
Affiliation: <sup>1</sup>Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA. nijja003@umn.edu.
<sup>2</sup>Biostatistics, Epidemiology and Research Design (BERD), University of Minnesota, Minneapolis, Minnesota, USA.
<sup>3</sup>Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA.
<sup>4</sup>School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
<sup>5</sup>Cardiac Rehabilitation, Fairview Health Services, Minneapolis, Minnesota, USA.
<sup>6</sup>Program in Health Disparities Research, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
<sup>7</sup>Earl E Bakken Center for Spirituality & Healing, University of Minnesota, Minneapolis, Minnesota, USA.
Conference/Journal: Sci Rep.
Date published: 2019 Dec 5
Other:
Volume ID: 9 , Issue ID: 1 , Pages: 18415 , Special Notes: doi: 10.1038/s41598-019-54932-2. , Word Count: 276
Currently, exercise-based cardiac rehabilitation (CR) is the only recommended secondary prevention strategy for cardiac patients that attempts to tackle stress and psychosocial wellbeing, but it is under-utilized and lacks a comprehensive curriculum for this purpose; hence there is a critical gap to address psychosocial needs of cardiac patients after an event. Mindfulness-based stress reduction (MBSR) has shown benefits in the general population but its role in cardiac patients is not clear. We conducted a pilot randomized controlled trial (RCT) of MBSR in CR-eligible cardiac patients during their initial year of recovery. Patients were allocated 2:1 (intervention:control) to an 8-week MBSR group intervention or usual care. Standard measures of depression, anxiety, perceived stress, health related quality of life (HRQOL), blood pressure, biomarkers (lipids, HbA1c, CRP) and 24-hour Holter monitoring were obtained at baseline, 3- and 9-months post-randomization. Sub-group analyses were performed for participants with at least mild depression (PHQ-9 ≥ 5). 47 patients [mean age 58.6 years; 38% female; 77% white] were enrolled in 2 cohorts. 87% of MBSR patients completed the intervention; study retention was >95% at each follow-up visit. At 3 months, compared to controls, MBSR patients showed improvements in depression [p = 0.01] and anxiety [p = 0.04] with a similar trend in HRQOL [p = 0.06]. The MBSR group showed greater improvement or less worsening of most CV risk factors, with an attenuation of treatment effects at 9 months. Participants with at PHQ-9 scores ≥5 at baseline showed greater improvement in psychosocial and CV outcomes, that persisted at 9 months. MBSR is a safe and well received secondary prevention strategy. This pilot RCT provides preliminary evidence of MBSR's potential to improve short term psychosocial well-being in cardiac patients during their first year of recovery.
PMID: 31804580 DOI: 10.1038/s41598-019-54932-2