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Drugs such as beta-blockers and psychosocial interventions can reduce the physiologic response to some forms of stress.
In patients with known coronary disease, the cardioprotective effect of beta blockers with regard to heart attack and sudden cardiac death are partly due to a diminution of catecholamine and hemodynamic-induced endothelial damage and a rising of the threshold for ventricular fibrillation.
In patients at risk for cardiovascular events who are under increased psychosocial stress, a stress management program can be considered as part of an overall preventive strategy, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President, Heart Care Foundation of India. In premature heart attack, the mean age is 53-54 yrs.
In general, the goal of a stress management program is to reduce the impact in the individual of stressful environmental events and to better regulate the stress response.
- Interventions may be considered at several levels:
- · Removal or alteration of the stressor
- · Change in perception of the stressful event
- · Reduction in the physiologic sequelae of stress
- · Use of alternative coping strategies
Stress management techniques typically include components of muscular relaxation, a quiet environment, passive attitude and deep breathing with the repetition of a word or phrase.
The physiologic changes produced include a decrease in oxygen consumption, reduced heart rate and respiratory rate and passive attitude and muscular relaxation. Such changes are consistent with a decrease in sympathetic nervous system activity.
Other measures, such as relaxation techniques and biofeedback, can produce a small reduction in blood pressure of 5 to 10 mmHg.
Behavior modification programs are also an important adjunct to smoking cessation and have been associated with a reduction in cigarette consumption. Improvements in compliance with medication regimens may be an additional benefit from stress reduction program.
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