Journal
ARCHIVES OF INTERNAL MEDICINE
Volume 171, Issue 2, Pages 134-140Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archinternmed.2010.510
Keywords
-
Categories
Funding
- Swedish Medical Research Council [K97-21X-12256-01A, K98-21X-12256-02B, K99-21X-12256-03C]
- Vardal foundation [V96-160, V98-403]
- Swedish Council for Working Life and Social Research [F0196/99, 2001-1049]
- Swedish National Board of Health and Welfare [1471-601:Var95-161]
- Swedish Heart and Lung Association [E010-95, E019-96, E019-98, E010-00, E009-01, E45-04]
- Uppsala Primary Health Care Administration
- Uppsala University
Ask authors/readers for more resources
Background: Psychosocial factors are independently associated with increased risk of cardiovascular disease(CVD) morbidity and mortality, but the effects of psychosocial factor intervention on CVD are uncertain. We performed a randomized controlled clinical trial of cognitive behavioral therapy (CBT) to measure its effects on CVD recurrence. Methods: The study included 362 women and men 75 years or younger who were discharged from the hospital after a coronary heart disease event within the past 12 months. Patients were randomized to receive traditional care (reference group, 170 patients) or traditional care plus a CBT program (intervention group, 192 patients), focused on stress management, with 20 two-hour sessions during 1 year. Median attendance at each CBT session was 85%. Outcome variables were all-cause mortality, hospital admission for recurrent CVD, and recurrent acute myocardial infarction. Results: During a mean 94 months of follow-up, the intervention group had a 41% lower rate of fatal and non-fatal first recurrent CVD events (hazard ratio [95% confidence interval], 0.59 [0.42-0.83]; P=.002), 45% fewer recurrent acute myocardial infarctions (0.55 [0.36-0.85]; P=.007), and a nonsignificant 28% lower all-cause mortality (0.72 [0.40-1.30]; P=.28) than the reference group after adjustment for other outcome-affecting variables. In the CBT group there was a strong dose-response effect between intervention group attendance and outcome. During the first 2 years of follow-up, there were no significant group differences in traditional risk factors. Conclusions: A CBT intervention program decreases the risk of recurrent CVD and recurrent acute myocardial infarction. This may have implications for secondary preventive programs in patients with coronary heart disease.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available