Randomized Trial of Mindfulness-Based Stress Reduction in Cardiac Patients Eligible for Cardiac Rehabilitation

Prabhjot S. Nijjar, John E. Connett, Ruth Lindquist, Roland Brown, Marsha Burt, Aaron Pergolski, Alexandra Wolfe, Priya Balaji, Nitya Chandiramani, Xiaohui Yu, Mary Jo Kreitzer, Susan A. Everson-Rose

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Currently, exercise-based cardiac rehabilitation (CR) is the only recommended secondary prevention strategy for cardiac patients that attempts to tackle stress and psychosocial wellbeing, but it is under-utilized and lacks a comprehensive curriculum for this purpose; hence there is a critical gap to address psychosocial needs of cardiac patients after an event. Mindfulness-based stress reduction (MBSR) has shown benefits in the general population but its role in cardiac patients is not clear. We conducted a pilot randomized controlled trial (RCT) of MBSR in CR-eligible cardiac patients during their initial year of recovery. Patients were allocated 2:1 (intervention:control) to an 8-week MBSR group intervention or usual care. Standard measures of depression, anxiety, perceived stress, health related quality of life (HRQOL), blood pressure, biomarkers (lipids, HbA1c, CRP) and 24-hour Holter monitoring were obtained at baseline, 3- and 9-months post-randomization. Sub-group analyses were performed for participants with at least mild depression (PHQ-9 ≥ 5). 47 patients [mean age 58.6 years; 38% female; 77% white] were enrolled in 2 cohorts. 87% of MBSR patients completed the intervention; study retention was >95% at each follow-up visit. At 3 months, compared to controls, MBSR patients showed improvements in depression [p = 0.01] and anxiety [p = 0.04] with a similar trend in HRQOL [p = 0.06]. The MBSR group showed greater improvement or less worsening of most CV risk factors, with an attenuation of treatment effects at 9 months. Participants with at PHQ-9 scores ≥5 at baseline showed greater improvement in psychosocial and CV outcomes, that persisted at 9 months. MBSR is a safe and well received secondary prevention strategy. This pilot RCT provides preliminary evidence of MBSR’s potential to improve short term psychosocial well-being in cardiac patients during their first year of recovery.

Original languageEnglish (US)
Article number18415
JournalScientific reports
Volume9
Issue number1
DOIs
StatePublished - Dec 5 2019

Bibliographical note

Funding Information:
We would like to thank all the study participants and the study team. This project was supported by a Grant-in-Aid of Research, Artistry, and Scholarship to Dr. Everson-Rose from the Office of the Vice President for Research, University of Minnesota; and the University of Minnesota’s Clinical & Translational Science Institute (CTSI) through the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) Award Number UL1TR000114. Additional funding was provided by the Program in Health Disparities Research, the Division of Cardiology, and the Masonic Cancer Center at the University of Minnesota. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, NCATS or the other funders.

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