Stress management programs for heart patients are a must

Drugs such as beta-blockers and psycho social interventions can reduce the physiologic response to some forms of stress.

In patients with known coronary disease, the cardio protective effect of beta blockers with regard to heart attack and sudden cardiac death are partly due to a diminution of catecholamine and hemodynamic-induced endothelial damage and a rise in the threshold for ventricular fibrillation.

“In patients at risk of cardiovascular events because of increased psycho social stress, a stress management program can be considered as part of an overall preventive strategy. In a premature heart attack, the mean age is 53-54 yrs,”, said Padma Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India and Honorary Secretary General IMA.

In general, the goal of stress management programs is to reduce the impact of stressful environmental events in the individual and to regulate better the stress response.

Interventions may be considered at several levels:
Removal or alteration of the stressor
Change in perception of the stressful event
Reduction in the physiologic sequelae of stress
Use of alternative coping strategies

Stress management techniques typically include components of muscular relaxation, a quiet environment, passive attitude and deep breathing with the repetition of a word or phrase.

The physiologic changes produced include a decrease in oxygen consumption, reduced heart rate and respiratory rate and passive attitude and muscular relaxation. Such changes are consistent with a decrease in sympathetic nervous system activity.

Other measures, such as relaxation techniques and biofeedback, can produce a small reduction in blood pressure of 5 to 10 mmHg.

Behavior modification programs are also an important adjunct to smoking cessation and have been associated with a reduction in cigarette consumption. Improvements in compliance with medication regimens may be an additional benefit from stress reduction program.