Heart/Blood Pressure Research (53)
Researchers from the University of Wisconsin's School of Nursing performed a systematic review of the efficacy of relaxation, meditation and guided imagery on symptom management for heart failure, such as pain, dyspnea, fatigue, and sleep disruption.
Data bases such as CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral (mind-body) strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life.
Thirteen articles describing 9 unique studies met the criteria and were included in the review. Five studies tested relaxation strategies, 3 tested meditation strategies, and 1 tested a guided imagery strategy.
Researchers from the UCLA School of Nursing evaluated a program of early, home based cognitive behavioral therapy (CBT) program to remediate depression in patients recovering from cardiac surgery.
They conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms, using the Beck Depression Inventory (BDI) in the hospital and 1 month later. Patients were also interviewed using the Structured Clinical Interview for DSM-IV; those who met criteria for clinical depression (n = 81) were randomized to CBT (n = 45) or usual care (UC; n = 36). After completion of the UC period, 25 individuals were offered later CBT (UC + CBT).
The outcomes were evaluated after 8 weeks. Compared with the Usual Care group, the CBT group had greater decline in depression scores and greater remission of clinical depression.
Researchers from the Brain and Mind Research Institute at the University of Sydney in New South Wales, Australia, evaluated the effectiveness of internet-delivered Cognitive Behavioral Therapy (iCBT) on depressive symptom severity and adherence to medical advice (including lifestyle interventions) in adults with mild to moderate depression and high cardiovascular disease (CVD) risk.
This was a randomized, double-blind, 12 week attention-controlled trial comparing an iCBT program (E-couch) with an internet-delivered attention control health information package (HealthWatch, n = 282).
The primary outcome measured was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12610000085077).
Out of 562 subjects, there were 487 completers (88%) who lasted to the final assessment.
Gulf Medical University in Ajman, United Arab Emirates, and Medical College Trivandrum in Kerala, India, assessed the efficacy of yoga in managing dyslipidemia in patients with type 2 diabetes.
Patients (n=100) were randomly assigned to either a yoga group or a control group. The yoga subjects practiced one hr/day for three months, while receiving oral hypoglycemic medication.
The controls received medication only (treatment as usual).
Lipid profiles of both groups were compared at the start and at the end of the three months.
In a feasibility study at the Johns Hopkins Bloomberg School of Public Health, investigators looked at whether Mindfulness-Based Stress Reduction (MBSR) could decrease blood pressure in low-income, urban, African-American older adults, and whether such an intervention would be acceptable to and feasible with minority, low income, older adults when provided at home.
The study was launched because (1) hypertension affects a large proportion of urban African-American older adults; and (2) many older adults don’t have access to medications and/or don’t take them when they do have them.
Participants were at least 62 years old and residents of a low-income senior residence. All were African-American, mostly female. Twenty participants were randomized to the mindfulness-based intervention or a social support control group, both of which were 8 weeks duration.
Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention.
Investigators from the University of Michigan School of Nursing in Ann Arbor examined the effects of using our Healthful Sleep guided imagery on post-cardiac surgery sleep disturbances (problems with sleep quality, time taken to fall asleep and total sleep time) and systemic inflammatory response, as measured by stress hormones and inflammatory markers, including cortisol and C-reactive proteins. These post-surgical difficulties are exacerbated when a patient is put on a bypass machine, and are predictors of post-op morbidity and mortality.
Of the 52 patients who provided informed consent, 27 were randomly assigned to the guided imagery group and 25 to usual care only during the ICU and step-down phases of post-op recovery. Of these, 5 in each group were lost to follow-up.
Researchers from the Institute of Neurological Sciences, South Glasgow University in Scotland, UK, investigated whether Reiki has any impact on indices of autonomic nervous system function – heart rate, blood pressure, baroreflex response, cardiac vagal tone and breath rate.
Forty-five subjects were assigned at random into three treatment conditions: no treatment (rest only); Reiki treatment by an experienced Reiki practitioner; and placebo treatment by a person with no knowledge of Reiki but who mimicked the Reiki treatment.
Researchers from the University of New South Wales in Sydney, Australia launched a small feasibility study to assess the impact of the Bonny Method of Guided Imagery and Music on six outpatients in cardiac rehabilitation, as part of their treatment plan to effectively marshall physical, psychological, and vocational strategies to restore and sustain optimal health.
Starting 6 to 15 weeks after cardiothoracic surgery, 6 study participants were recruited for 6 weekly music therapy (BMGIM) sessions. Qualitative analysis of the patient narrative within a semiotic framework demonstrated that patients used music therapy to spontaneously explore their recovery process.
Researchers from the Department of Surgery at Columbia University in New York examined whether guided imagery could reduce depression and therefore post-op cardiac events and even deaths (associated with depression) in patients who’d undergone coronary artery bypass graft (CABG) surgery.
Traci Stein and her team hypothesized that this low cost and easy-to-implement technique could reduce post-op distress in CABG patients. Fifty-six patients were randomized into 3 groups: guided imagery, music therapy, and standard care control.
Patients in the imagery and music groups listened to Health Journeys audiotapes preoperatively and intraoperatively. All patients completed psychological, complementary medicine therapies use, and other assessments preoperatively and at 1 week and 6 months postoperatively.
Researchers from the Pain Division of the Department of Anesthesiology at Columbia University in New York, concerned about the connection between depression/anxiety and the postoperative risk of a patient having a cardiac event after coronary artery bypass graft surgery (CABG), explored whether guided imagery might reduce postoperative distress in these patients.
Fifty-six patients scheduled to undergo coronary artery bypass grafting at Columbia University Medical Center were randomized into 3 groups: guided imagery, music therapy, and standard care control. Patients in the imagery and music groups listened to audiotapes preoperatively and intraoperatively. All patients completed psychological assessments, disclosure of their use of CAM therapies, and other assessments before surgery and after one week and 6 months postoperatively.