April 5, 2005 -- Exercise and stress management -- along with standard medical care -- could help the hearts of people with stable heart disease.
Heart disease is a leading killer in the U.S. Many people learn that they have heart disease before it's too late. For them, exercise and stress management might be beneficial, says a study in The Journal of the American Medical Association.
Of course, those techniques aren't intended to replace conventional care. Patients would also need careful medical supervision during such programs. Even if you don't have heart disease, it's a good idea to check in with a doctor first about exercise and stress issues.
The results suggest "considerable benefit" from exercise and stress-management training, write the researchers, who included James Blumenthal, PhD, of Duke University.
Not only did exercise and stress management lower markers of heart disease, but they were also associated with a reduction in patients' emotional distress. In short, their hearts became healthier, and their states of mind improved.
The study was relatively short and small, so long-term benefits aren't known yet. But early indications look promising, says the report.
Participants were 134 people (92 men and 42 women). They were 40-84 years old and had stable heart disease.
First, they took several tests. Medical imaging pictured their heart and blood vessels. Mental stress tests were also given. In one task, participants had to give a speech on a controversial issue in front of judges, with only a minute to prepare.
Next, participants were split into three groups. All got standard medical care. On top of that, some got a formal exercise or stress management program.
The exercise group worked out for 35 minutes three times a week for 16 weeks. They continued their usual medical care. Each exercise session was supervised.
The second group didn't get a formal exercise program. Instead, they took a weekly 1.5-hour stress management class for four months, along with standard care. They learned ways to handle stress constructively. For instance, they got instruction on relaxation, imagery, problem solving, and time management.
The stress class had two core ideas: People's thinking largely drives their emotions and behavior, and stress is an imbalance between excessive demands and inadequate coping skills. Address those issues and stress becomes easier to handle, the theory goes.
Both exercise and stress management appeared beneficial. Both programs lowered markers of heart disease risks.
In the study, the ability of the participants' blood vessels to respond to changes in blood flow improved by about 25%.
Their heart images also showed less of a decline in the heart's pumping function.
The exercise and stress management groups also showed less emotional distress and depression than the participants who did not receive that type of care. Distress and depression have been linked to worse outcomes in heart patients.
However, a bigger, longer study is needed to track long-term outcomes, say the researchers. But the findings could provide new clues about how exercise and stress management help the heart, they say.
Besides exercise, stress management, and medical care, there are other helpful strategies that can fight heart disease. Not smoking, eating healthfully, and maintaining a healthy weight are also heart-friendly practices.