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To determine the effect of mindfulness-based stress reduction program, with routine medical care on psychosocial functioning and markers of cardiovascular risk.
Randomized controlled trial of 146 patients (86 male and 60 female; aged 45-79 years) with stable ischemic heart disease (IHD) and exercise-induced myocardial ischemia. Conducted from January 2015 to January 2017. Routine medical care (usual care); usual care plus mindfulness-based stress reduction program for 2.5-h 2 times per week for 12 weeks; Main Outcome Measures included Self-reported measures of general distress (General Health Questionnaire [GHQ]) and depression (Beck Depression Inventory-2nd edition [BDI-2]); wall motion abnormalities (WMA) and left ventricular ejection fraction (LVEF); cardiac autonomic control (heart rate variability during deep breathing and baroreflex sensitivity); and flow-mediated dilation.
Patients in the mindfulness-based stress reduction group had lower mean (SE) BDI-2 scores (mindfulness-based stress reduction: 7.9 [0.5]) vs usual care (11.2 [0.7]; P = .01); reduced distress by GHQ scores (mindfulness-based stress reduction: 58.9 [1.0]) vs usual care (52.1 [0.8]; P = .01); and smaller reductions in LVEF during mental stress testing (mindfulness-based stress reduction: −0.24% [0.44%]) vs usual care (−1.81% [0.47%]; P = .02). Mindfulness-based stress reduction group was associated with lower mean (SE) WMA rating scores (mindfulness-based stress reduction: 0.11 [0.06]) in a subset of patients with significant stress-induced WMA at baseline vs usual care (0.39 [0.08]; P = .02). Patients in the mindfulness-based stress reduction group had greater mean (SE) improvements in flow-mediated dilation (mindfulness-based stress reduction: 6.1% [0.45%]) vs usual care patients (4.3% [0.47%]; P = .02). In a subgroup, those receiving mindfulness-based stress reduction program showed improved mean (SE) baroreflex sensitivity (7.9 [0.9] ms/mm Hg) vs usual care (4.8 [0.8] ms/mm Hg; P = .02) and significant increases in heart rate variability (196.5 [20.4] ms) vs usual care (128.3 [22.7] ms; P = .02).
For patients with stable IHD, mindfulness-based stress reduction program reduced emotional distress and improved markers of cardiovascular risk more than usual medical care alone.