Targeting psychosocial factors in cardiac rehabilitation of young women to reduce cardiovascular events following myocardial infarction

Date
2021
DOI
Authors
Patel, Neha
Version
OA Version
Citation
Abstract
Cardiovascular disease (CVD) accounts for the highest mortality rates in the US for both men and women. Yet, heart disease continues to be under recognized in women. Notably, the incidence of myocardial infarction and related mortality rates are higher in younger women than their male counterparts. This disparity can be explained by a myriad of sex-based differences. It has been reported that young women face a higher burden of psychosocial risk factors such as depression, anxiety and low social support that contributes to worse outcomes following myocardial infarction. Prior studies have shown a mortality benefit from a psychosocial intervention post myocardial infarction in women; however, this has not been studied in the young women population in the US. The proposed study is a multicenter, randomized controlled trial that is specifically designed to evaluate the effects of cognitive behavioral therapy in women < 55 years old following myocardial infarction compared to traditional cardiac rehabilitation. The intervention will distribute women into small groups where they will participate in cognitive behavioral therapy led by a psychologist that will not only educate participants in how to reduce their cardiac risk factors but also their psychosocial risk factors. The aim will be to target different stressors whether work related, marital, or familial and increase participant’s social support. The control group will participate in traditional cardiac rehabilitation including education around cardiac risk factors and a supervised exercise program. The intervention will run over the span of one year and the outcomes measured will be 5-year mortality rate and number of rehospitalizations for cardiovascular events. The results of the study can help identify an alternative rehabilitation option for women following myocardial infarction that is effective in reducing mortality rates and rehospitalizations. Furthermore, the study can elucidate the importance of shifting focus from the traditional cardiac risk factors to targeting psychosocial risk factors in the general population to reduce events and improve outcomes in young women following myocardial infarction.
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