Psychological interventions in cardiovascular disease: an update.

PURPOSE OF REVIEW To evaluate recent literature on psychological interventions in cardiovascular disease. RECENT FINDINGS Mindfulness-based stress reduction did not reduce blood pressure, and a self-management programme in heart failure patients (HART), showed no improvement in health-related quality of life. Web-based decision aids are as effective as individually tailored counseling at reducing cardiovascular risk. Among health attack survivors, the ProActive Heart study involving telephone delivered counseling reduced anxiety whereas integrated motivational interviewing cognitive behavioral therapy (Beating Heart Problems) reduced depression and anger with no physiological or behavioral benefits. SUMMARY Psychological conditions increase cardiovascular risk as well as complicate cardiovascular disease. Psychological interventions are, however, far less studied compared with pharmacological and device therapies for cardiovascular disease. Interventions can either be delivered in isolation or in combination with other interventions including education, exercise, and medications, whereas outcomes measured could include psychometrics, behavior, risk scores, cardiovascular endpoints, and mortality. Due to the large variety of possible interventions and outcomes, published studies have reported mixed results and it remains unclear which modes of delivery and which types of intervention are most appropriate.