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:
1Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA. nijja003@umn.edu.
2Biostatistics, Epidemiology and Research Design (BERD), University of Minnesota, Minneapolis, Minnesota, USA.
3Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA.
4School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
5Cardiac Rehabilitation, Fairview Health Services, Minneapolis, Minnesota, USA.
6Program in Health Disparities Research, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
7Earl 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
