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Study Links Stress To Heart Disease Learning To Relax Reduces Risk Of Heart Attack

To stave off heart disease, the No. 1 killer in America, everyone knows the drill: lose weight, stop smoking, eat well and exercise. But stop sadness? Control hostility? Learn to relax?

Researchers at Duke University in North Carolina have found that relaxation, feeling better about yourself and managing emotional and psychological stress can profoundly reduce the risk of coronary artery disease - which affects a staggering 13.5 million Americans each year and costs $117 billion in treatment and lost productivity.

After a five-year study of 107 patients with heart disease, researchers announced Sunday that patients who learned to manage stress reduced their risk of having another heart attack or heart problems by 74 percent when compared to patients receiving medication only. Reducing mental stress also proved more beneficial than getting exercise.

“That was a really striking finding,” said one of the authors, Dr. James Blumenthal, a psychologist at Duke. “We’re hoping the results will increase physicians’ awareness of the importance of stress management in their care of patients and that just prescribing medications may not be sufficient.”

While much of the study’s conclusions may seem like common sense, both Blumenthal and other heart specialists say this is the first hard evidence that reducing stress reduces heart disease. And in order to make stress reduction a common medical practice - one covered by insurance plans - it is critical to have such evidence, Blumenthal said.

Blumenthal presented his findings Sunday at an American Medical Association conference here. The study will be published next week in the AMA’s Archives of Internal Medicine.

To conduct the study, which was sponsored by the National Heart, Lung and Blood Institute, Blumenthal first gave the heart patients a battery of personality, physical and mental stress tests. They filled out surveys, walked on treadmills, solved math problems in their heads and wore heart monitors at home for 48 hours.

Then the 107 heart patients, primarily white men, were divided into three groups. Forty received standard care only, medication to reduce blood pressure or aspirin or monitoring from their physicians. Thirty-four were assigned to an exercise group and, in addition to receiving their usual medication, worked out vigorously for 35 minutes three times a week. Thirty-three others came to an hour-and-a-half group therapy and stress management meeting once a week, as well as take their medication.

Over four months, the stress management group learned about irritable and impatient “type A” behaviors. They began to recognize how their bodies seized up when they got angry or stressed when, say, someone cut in front of them in traffic or they had to wait in line, through biofeedback - sophisticated monitoring equipment that measures when muscles tense or relax.

They learned how to redirect the defeatist thoughts that often plague heart attack survivors, like, “I’ll never live to see my kids grow up.” They listened to relaxation tapes at home. And they shared their feelings.