Heart/Blood Pressure - Guided Imagery and Meditation Blog | Health Journeys http://blog.healthjourneys.com Mon, 22 May 2017 17:31:51 -0400 Joomla! - Open Source Content Management en-gb Internet-Delivered CBT Reduces Depression in At-Risk Heart Patients http://blog.healthjourneys.com/hot-research/cbt-reduces-depression-in-heart-patients.html http://blog.healthjourneys.com/hot-research/cbt-reduces-depression-in-heart-patients.html

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.

Of those, 383 (70%) were being treated for cardiovascular disease and 314 (56%) had at least one other co-morbid condition.

In the ITT analysis of the 562 participants, results showed that the iCBT condition produced a greater decline in the mean PHQ-9 (depression) score, as compared to the attention control of 1.06 (95% CI: 0.23-1.89) points.

Differences between the two arms increased over the intervention period (time by treatment effect interaction p = .012).

There were also larger improvements in adherence to medical advice (2.16 points; 95% CI: 0.33-3.99), reductions in anxiety (0.96 points; 95% CI: 0.19-1.73), and a greater proportion engaging in beneficial physical activity (Odds Ratio 1.91, 95%CI: 1.01-3.61) in the iCBT participants.
 
There was no effect on disability.
 
The investigators conclude that in people with mild to moderate depression and high levels of CVD risk factors, a freely accessible iCBT program (http://www.ecouch.anu.edu.au) produced a small, but robust improvement in depressive symptoms, adherence and some health behaviors.

Citation: Glozier N1, Christensen H, Naismith S, Cockayne N, Donkin L, Neal B, Mackinnon A, Hickie I. Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: a randomised attention-controlled trial. PLoS One. 2013;8 (3):e59139. nick.glozier@sydney.edu.au

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 01 Jun 2014 20:00:00 -0400
Yoga Improves Dyslipidemia in People with Type 2 Diabetes http://blog.healthjourneys.com/hot-research/yoga-improves-dyslipidemia-in-people-with-type-2-diabetes.html http://blog.healthjourneys.com/hot-research/yoga-improves-dyslipidemia-in-people-with-type-2-diabetes.html

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.

After the three months of intervention, the yoga group showed significant decreases in total cholesterol, triglycerides and LDL; and an improvement in HDL.
 
The investigators conclude that yoga, being a lifestyle incorporating exercise and stress management training, targets the elevated lipid levels in patients with diabetes through integrated approaches.

Citation:   Shantakumari N, Sequeira S, El Deeb REffects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia. Indian Heart Journal. 2013 Mar-Apr;65 (2): pp. 127-31. nisha@gmu.ac.ae.

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 11 Aug 2013 20:00:00 -0400
Meditation Lowers Blood Pressure in Low Income, African American Seniors http://blog.healthjourneys.com/hot-research/meditation-lowers-blood-pressure-in-low-income-african-american-seniors.html http://blog.healthjourneys.com/hot-research/meditation-lowers-blood-pressure-in-low-income-african-american-seniors.html

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.

A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure scores, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the relationship between participation in the mindfulness-based intervention and the blood pressure scores.

Attendance remained 98% in all 8 weeks in both the experimental group and the controls. 

The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group at the end of the intervention period,  statistically significant at p=0.020.

The average diastolic blood pressure decreased in the intervention group (16.70-mmHg lower) at the end of the 8 weeks, while it increased in the social support group, statistically significant at p=0.003.

The researchers conclude that older adult women are at a time in life when a reflective, stationary intervention like MBSR, delivered in residence, could be an appealing mechanism to improve blood pressure. These preliminary results warrant larger trials in this hypertensive study population.

Citation:  Palta P, Page G, Piferi RL, Gill JM, Hayat MJ, Connolly AB, Szanton SL. Evaluation of a mindfulness-based intervention program to decrease blood pressure in low-income African-American older adults. Journal of Urban Health. 2012 Apr;89 (2): pages 308-16. ppalta@jhsph.edu

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 16 Jun 2013 20:00:00 -0400
Guided Imagery Reduces Inflammation, Sleep Trouble after Heart Surgery http://blog.healthjourneys.com/hot-research/guided-imagery-reduces-inflammation-sleep-trouble-after-heart-surgery.html http://blog.healthjourneys.com/hot-research/guided-imagery-reduces-inflammation-sleep-trouble-after-heart-surgery.html

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.

Patients were provided with MP3 players preloaded with Healthful Sleep; SleepPhones (a fleece headband with built in speakers worn over both ears) and spare batteries.  

The imagery was administered by the nurse between 10 pm and midnight and left on the nightstand for when the patient woke up during the night. Patients rated how well they liked the intervention, and sleep efficiency was measured by a wrist actigraph (ActiWatch).  Salivary cortisol and C-RP measures were taken between 6-8 am the following morning. Pain and anxiety levels were also rated.

Patients in the guided imagery group had consistently better sleep quality, more total sleep time, and took less time to fall asleep; and these improvements increased over time. Additionally, the guided imagery patients enjoyed a greater decline in inflammation over time, as measured by cortisol levels and C-reactive proteins. But the findings fell just short of significance. The patients liked the imagery and felt it helped them. Large scale studies are needed to establish conclusive evidence of the value of guided imagery for sleep and inflammation; in the meantime, the researchers conclude that imagery should complement other methods to promote sleep in hospitalized patients.

Citation:
Casida JM, Yaremchuk KL, Shpakoff L, Marrocco A, Babicz G, Yarandi H. The effects of guided imagery on sleep and inflammatory response in cardiac surgery: a pilot randomized controlled trial.  Journal of Cardiovascular Surgery (Torino). 2013 Apr; 54 (2): pp 269-79. Epub 2012 Nov 9. jcasida@umich.edu

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 02 Jun 2013 20:00:00 -0400
Some Mind-Body Suggestions to Help with Dangerous Hypertension, Please… http://blog.healthjourneys.com/ask-belleruth/some-mind-body-suggestions-to-help-with-dangerous-hypertension-please.html http://blog.healthjourneys.com/ask-belleruth/some-mind-body-suggestions-to-help-with-dangerous-hypertension-please.html

Question:

Dear Belleruth,

I am having a persistent problem with hypertension - high systolic numbers.  What would you recommend insofar as an appropriate CD or imagery technique, or perhaps meditation?  Your help will be a blessing and very much appreciated.  I have a multitude of other problems, but this one could kill me if I don't get it under control.  Again, thanks much.

David

Answer:

Dear David,

There are many research-proven mind-body methods to help you get your hypertension under control, to complement whatever allopathic methods you’re using.  It more depends on what suits you and is easiest for you to do – and therefore more likely you’ll stay with it on a regular basis – rather than being about one technique that works best above all others. 

If you like hypnosis, the gifted health psychologist, Dr. Carol Ginandes, has just come out with a new double CD set, Perfect Pressure, Healthy Heart. This is an extraordinarily skillful, comprehensive and powerful set of six hypnotic exercises designed to normalize blood pressure. I’m a big fan of her work, so if you’re comfortable with hypnosis (which isn’t all that different from guided imagery), and are up for working fairly comprehensively with 6 different exercises, you might want to start there. 

If you’re an imagery person, and just want to start with one meditation, our Healthy Heart imagery deals specifically with high blood pressure. But I should also add that any guided imagery that soothes and relaxes you is probably going to make a dent on your blood pressure – including Relieve Stress and Relaxation & Wellness.

If you think you might prefer a male voice offering 4 different exercises that use a more straightforward, hypnotic technique, you might want to try the awesome Emmett Miller’s Down with High Blood Pressure

And of course, we know from other studies that ™ (Transcendental Meditation) and Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction methods also work. 

Even something as simple as working with your breath, using Andy Weil’s excellent CD, can have a good effect on your blood pressure. 

My suggestion would be for you to listen to the sound samples on our site and just experiment a little until you find something that really appeals to you, and then just stick with that until you get totally sick of it, and then switch to something else that suits you. Luckily, there’s a lot to choose from. 

All best and good luck,
Belleruth
 

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design@emediacy.net (Belleruth Naparstek) Ask Belleruth Mon, 22 Apr 2013 06:31:34 -0400
Reiki Treatment Lowers Heart Rate, Blood Pressure http://blog.healthjourneys.com/hot-research/reiki-treatment-lowers-heart-rate-blood-pressure.html http://blog.healthjourneys.com/hot-research/reiki-treatment-lowers-heart-rate-blood-pressure.html

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.

Quantitative measures such as heart rate, cardiac vagal tone, blood pressure, cardiac sensitivity to baroreflex, and breathing activity were recorded continuously for each heartbeat.  Values during and after the treatment period were compared with baseline data.

The investigators found that subjects’ heart rate and diastolic blood pressure decreased significantly in the Reiki group, as compared to the placebo condition and/or the control condition.

The study indicates that Reiki has some effect on the autonomic nervous system. However, this was a pilot study with relatively few subjects and the changes were relatively small. The results justify further, larger studies to look at the biological effects of Reiki treatment.

Citation: 
Mackay N, Hansen S, McFarlane O. Autonomic nervous system changes during Reiki treatment: a preliminary study. Journal of Alternative Complementary Medicine. 2004 Dec;10 (6): pages 1077-81.

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 09 Sep 2012 20:00:00 -0400
Bonny Method Helps Cardiac Rehab Patients http://blog.healthjourneys.com/hot-research/bonny-method-helps-cardiac-rehab-patients.html http://blog.healthjourneys.com/hot-research/bonny-method-helps-cardiac-rehab-patients.html

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.

Five grand themes emerged: (1) looking through the frame, (2) feeling the impact, (3) spiraling into the unexpected, (4) sublime plateau, and (5) rehearsing new steps. The themes related to physical changes, adjustment after surgery, and anticipated lifestyle changes in the future.

The investigators concluded that the study demonstrated that music therapy (BMGIM) can be used to access and understand the internal recovery process of post-cardiothoracic surgical patients, and offer an additional clinical tool to augment the external rehabilitation process.

Citation: Short A, Gibb H, Fildes J, Holmes C. Exploring the Role of Music Therapy in Cardiac Rehabilitation After Cardiothoracic Surgery: A Qualitative Study Using the Bonny Method of Guided Imagery and Music. Journal of Cardiovascular Nursing. 2012 Jul 9. [Epub ahead of print]

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 22 Jul 2012 20:00:00 -0400
Does Guided Imagery Help with Depression after a Bypass? http://blog.healthjourneys.com/hot-research/does-guided-imagery-help-with-depression-after-a-bypass.html http://blog.healthjourneys.com/hot-research/does-guided-imagery-help-with-depression-after-a-bypass.html

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.

Investigators learned that only pre-operative distress was predictive of post-operative distress at follow-up.

Use of complementary medicine therapies was high in all groups and this fact, in addition to the small sample size, may have accounted for the lack of significant relationship between imagery and postoperative distress.

Regardless, this complementary and alternative medicine therapy was palatable to patients and used well. Given its efficacy in other patient populations, the researchers conclude that it is worth exploring for potential utility with this population, using a larger sample.

Citation: Stein TR, Olivo EL, Grand SH, Namerow PB, Costa J, Oz MC. A pilot study to assess the effects of a guided imagery audiotape intervention on psychological outcomes in patients undergoing coronary artery bypass graft surgery. Holistic Nursing Practice. 2010 Jul-Aug; 24 (4): pages 213-22. ts2007@columbia.edu

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design@emediacy.net (Belleruth Naparstek) Hot Research Sun, 24 Jun 2012 20:00:00 -0400
Coping with Wild Ups and Downs after a Heart Transplant http://blog.healthjourneys.com/ask-belleruth/coping-with-wild-ups-and-downs-after-a-heart-transplant.html http://blog.healthjourneys.com/ask-belleruth/coping-with-wild-ups-and-downs-after-a-heart-transplant.html

After being taken by surprise by a pretty typical, distressing, lurching, crazy emotional roller coaster ride following his heart transplant surgery, a man wonders if there is something he can do to alleviate or cushion his symptoms.  Here’s his comment and question:
 
Question:

I am wondering what you might suggest for patients undergoing heart transplants. I spent seven months in a hospital and can tell you the emotions and abandonment are unreal and I want to be able to suggest something other patients can do without help from others which will provide the benefit of mental imagery and not require the assistance of others. A cd player can be put on by a patient, everything else is a gift as there is always someone higher priority and everyone is busy with their own lives. Perhaps you can suggest something for me as well to manage what to do with all the emotional turmoil after surviving all the physical.

Dave

Answer:

Dear Dave,

Thanks very much for the question.  I'm happy to answer.  And posting it is a great way to alert others about the profound and often surprising impact of heart transplantation surgery.  People are rarely forewarned and are often knocked flat by the emotional wallop they experience.  Ultimately it may leave the person more in touch with their feelings in a permanent way – and that’s certainly not a bad thing.  But it can be pretty disorienting and feel pretty weird at first.

Any open heart surgery, really, will make for some very strong reactions.  It's not unusual to see long-buried posttraumatic stress get kicked loose, even from combat seen some 60 years ago during WWII and buried far from consciousness all that time.
 
All sorts of old traumas can resurface, which makes us think that these heartbreaking events are really and truly experienced by us in our hearts, and once we disrupt that amazing organ and its boundaries, all bets are off for business as usual, and the grief, pain, fear and sorrow all come flooding back!  We're only beginning to understand the effects of CABG (artery grafting) surgery, let alone what happens to our psyches and souls when we actually switch our heart for someone else's!
 
So I wouldn’t be surprised if your surgery unearthed some ancient abandonment issues you may have suffered earlier in your life.  Or, some would suggest that perhaps this abandonment came with the cellular intelligence of your adopted heart and it’s former experiences.  (I know that sounds pretty bizarre, but there is some evidence to suggest this, and the highly regarded mind-body psychologist Paul Pearsall even wrote a book about it: The Heart’s Code.  Another book called A Change of Heart: A Memoir by transplant survivor Claire Sylvia, describes her experience of picking up some of the characteristics and even food preferences of her young, male, teenage donor.)
 
Your suggestion for self-soothing and mood-regulating tools to hand a patient before, during and after this hugely disruptive and dysregulated time is spot on.  And in fact, patients can prepare for these surgeries by bringing along a CD player, as you suggest, or by uploading to their iPod or iPad, or by purchasing a Playaway, which is a preloaded player that you mostly see in libraries, hospitals and downrange in the military, because they're so handy, durable and convenient.

We have imagery that specifically targets the transplantation experience, but only as it applies to bone marrow transplants.  And although there are suggestions in that audio around the themes of accepting the gift of the transplant and not resisting or rejecting it; and the whole archetypal notion of renewal, rebirth and resurrection; it still has a lot of images in there that are unique to chemo and cancer.
   
So I suppose the imagery we have that would apply best would be our Successful Surgery CD, of course, for before; and also Relaxation & Wellness, Healing Trauma, General Wellness and maybe even Heartbreak, Abandonment & Betrayal or Ease Grief, as these surgeries do seem to evoke heart-based feelings of loss and sorrow along with opposing feelings of being profoundly moved by feelings of love and gratitude.
 
Perhaps later on the Self-Confidence & Peak Performance imagery would come in handy, as you start readying yourself to re-engage in daily activities of living. Bottom line: you would do well to be patient with this roller coaster ride as your body, mind and spirit learn to accommodate to this new heart.

So, at the risk of offering a real groaner of a pun, I say, "Take heart, Sir!!"  I wish you the very best of luck, and a successful, productive and love-filled future with your wonderful, life-saving new equipment.

All best wishes,

Belleruth

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design@emediacy.net (Belleruth Naparstek) Ask Belleruth Sun, 24 Jun 2012 20:00:00 -0400
Guided Imagery to Help Tolerate a Tracheotomy http://blog.healthjourneys.com/ask-belleruth/guided-imagery-to-help-tolerate-a-tracheotomy.html http://blog.healthjourneys.com/ask-belleruth/guided-imagery-to-help-tolerate-a-tracheotomy.html

Question:

Do you have a CD, cassette or download that would help my 85 year old father-in-law, who's got a tracheotomy following a heart attack & weeks of sedation?

He's not depressed, per se, but he is frustrated with the trach & is interested in guided imagery/self-hypnosis.  He's a retired psychologist & musician - a great guy.
 
A mental vacation with imagery of strengthening and regaining his health - hopefully without reference to breathing through his nose or mouth - would be great.
 
Thanks,  Theresa

Answer:

Dear Theresa,

He’s a lucky guy to have a daughter-in-law like you, who “gets” him, appreciates him and hustles for him!  I agree that a mental vacation is just the ticket, and with his psychological mindedness and musical background, he’s an ideal end-user for guided imagery or any hypnotic technique.
 
I sorted through a lot of audio, looking for something without some initial breathing instruction, but, unfortunately, most of the imagery that takes you to your ‘happy place’ starts with some initial breathing instruction.  For better or worse, that’s usually the first building block I use at the outset of my narratives, to ultimately take the listener to a nice, deep, altered state.
 
But you can always tell him to just ignore that part or just skip ahead and start with the part that follows (which, on my tapes usually goes like this: :And now, see if you can imagine a place…

However, I apparently did have the good sense to leave out the breathing instructions on the Cardiac ICU & Rehab imagery and, actually, a lot of the imagery on there could be useful to him.  It’s about mending and healing, tolerating and maybe even appreciating whatever machinery and mechanical help you have to put up with, and letting others take care of you, even if it feels weird… stuff like that.
 
Best wishes to both of you.

Belleruth

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design@emediacy.net (Belleruth Naparstek) Ask Belleruth Sun, 15 Jan 2012 19:00:00 -0500