Stress Management, Exercise May Aid Heart Patients

NEW YORK (Reuters) - Both exercise and stress management may help people with heart disease improve the well-being of their hearts and minds, a new study suggests.

Researchers found that adding either supervised exercise or stress management classes to patients' medical care eased their emotional stress and improved several indicators of heart and blood vessel function.

These indicators -- such as the dilation of blood vessels in response to blood flow -- are known to be related to a heart disease patient's prognosis. The new findings suggest that behavioral therapies can alter them, said lead study author Dr. James A. Blumenthal, of Duke University Medical Center in Durham, North Carolina.

"These kinds of interventions should be incorporated into routine medical treatment," he said in an interview.

The study, published in Wednesday's issue of the Journal of the American Medical Association, involved 134 men and women with diseased heart arteries, many of whom had survived a heart attack.

The patients were randomly assigned to either stay with their usual medical care, or to add an exercise program or stress management training. Those in the exercise group had a supervised workout three times a week for four months, which included riding a stationary bike, walking and jogging. Those in the stress management group had weekly small-group meetings in which they learned about stress and ways to cope with it.

Blumenthal and his colleagues found that patients in both groups showed reductions in emotional distress and depression symptoms, as measured by standard questionnaires.

They also showed physiological changes, including improvements in blood vessel dilation that were greater than those seen in patients on standard care. In addition, patients who underwent stress management training had improvements in certain measures of nervous system control of the heart.

Whether the changes in these biological markers will translate into fewer complications or lower death rates over time is unknown, according to Blumenthal. Larger studies, he said, are needed to look into that question.

One of the main points from the current study, Blumenthal noted, is that the patients did not come into it complaining of emotional distress or depression -- yet levels of both declined with exercise or stress management training.

This, he said, suggests that many people with heart artery disease could potentially benefit from the therapies.

It's not surprising that exercise would boost blood vessel function in heart patients, but exactly why stress management did so is unclear, according to Blumenthal.

In past research, he and his colleagues had already found that stress management seemed to benefit heart patients' physical health. The new findings, Blumenthal said, suggest that improved blood vessel function could be one of the reasons stress management works.

SOURCE: Journal of the American Medical Association, April 6, 2005.