Understanding How to Improve Cardiac Rehabilitation for Women
Teresa Caulin-Glaser, M.D.,Associate Professor of Internal Medicine (Cardiology)
Cardiovascular disease is the leading cause of death among women in the United States, and has claimed the lives of more women than men in every year since 1984. Increasing evidence suggests that psychological factors influence recovery from heart attack, yet psychological symptoms are frequently unrecognized and untreated, particularly in older women with heart disease. Dr. Caulin-Glaser studied the use of complementary medicine techniques added to traditional cardiac rehabilitation to enhance psychological determinants of positive outcome after heart attack, angioplasty or coronary bypass surgery.
Highlighted Study Findings
Recent studies have demonstrated that depression and stress may aid in the development of heart disease by contributing to inflammation of coronary arteries. Traditional cardiac rehabilitation programs are recommended as part of therapy after cardiac events in order to control cardiac symptoms, decrease the risk of another heart attack and death, and prevent progression of the disease. It has been shown that women respond less well to traditional rehabilitation. In this investigation, Dr. Caulin-Glaser studied a complementary medicine technique known as guided imagery, added to traditional cardiac rehabilitation, for women who have had a heart attack, angioplasty or coronary bypass surgery. Guided imagery is a process of creating a mental image to help a patient achieve a state of relaxation. The results demonstrated that women are significantly more depressed after a cardiac event compared to men, and the addition of guided imagery to cardiac rehabilitation was associated with a greater improvement in depressive symptoms compared to cardiac rehabilitation alone, especially in women. Finally, the addition of guided imagery to traditional cardiac rehabilitation was associated with a significant decrease in markers of inflammation affecting arteries. This research advanced understanding of the importance of assessing multiple risk factors for cardiac disease, including psychological symptoms such as depression, and demonstrated promise for novel techniques related to complementary medicine to improve cardiac rehabilitation programs for women and improve outcomes for women after heart attack.
Pilot Project Study was funded in 2001, Dr. Caulin-Glaser is now at the McConnell Heart Health Center, OH