Background
Cardiovascular Diseases (CVD) are the leading cause for mortality globally and contribute significantly to disability and morbidity. The guidelines on CVD prevention in clinical practice of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC) define blood apolipoprotein-B-containing lipoproteins, elevated blood pressure, smoking, diabetes mellitus and obesity as the main causal and modifiable risk factors in CVD. Stress is reported to highly correlate with behavioral risk factors, such as smoking and poor adherence to a healthy lifestyle. In doing so, it is classified as a potential risk modifier.
Cardiac rehabilitation aims to reduce the risk of further cardiovascular events and cardiovascular mortality. Secondary prevention is one of the main goals of cardiac rehabilitation, part of it being the topic of stress management.
Mindfulness-based stress reduction (MBSR) is a concept originally developed with the purpose of decreasing psychological distress in different somatic diseases. The concept aims to help subjects in discerning primary sensory experiences from emotional or cognitive processes. While there is a body of evidence for the effects of MBSR on chronic pain, symptoms of anxiety and depression, blood pressure and resting heart rate in various patient populations and healthy individuals, available data in cardiovascular patients is scarce. The reduction of resting blood pressure is the only outcome of MBSR-techniques in cardiovascular patients substantiated by statistical significance to date.
Hence, the aim of this research project is to explore the effects of MBSR on mental health, quality of life and risk factors in cardiovascular patients.
Methods
Patients will be recruited at the inpatient cardiac rehabilitation of the Hochgebirgsklinik Davos. The participants will be randomized into an intervention- or a control group, after giving their written consent. The intervention group will visit 2 weekly MBSR sessions, additionally to their usual rehabilitation program for the duration of their stay, while the control group receives written patient education about stress and relaxation techniques on the first week of rehabilitation. Mental health and Quality of Life will be assessed via the Hospital Anxiety and Depression Scale (HADS), the MacNew Heart Questionnaire and the Health- Related Quality of Life questionnaire (HRQoL). Further, the LDL- Cholesterol, smoking history, resting blood pressure, heart rate variability and HbA1c are going to be analyzed. Measurement points are at the clinic entry day and after 24±4 days, at the end of the rehabilitation.
Relevance of the expected results for research and clinical practice
In the face of the challenges that a growing prevalence of CVD and its risk factors poses to the Swiss health care system, the importance of secondary prevention seems crucial. In order to contain increasing health costs, but, more importantly, to empower patients and promote individual responsibility, it is important to explore preventive tools that can be applied simply and without further expense after cardiovascular rehabilitation. The research of the effects of MBSR as one of these tools could contribute to this.
Quiz question
Stress...
kann vermieden werden, wenn man täglich Entspannungsübungen macht.
wird als Risikofaktor klassifiziert, beeinflusst also die kardiovaskuläre Sterblichkeitsrate.
wird als Risikofaktorenmodulator klassifiziert, beeinflusst also kardiovaskuläre Risikofaktoren.