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SAN DIEGO– Mindfulness-based stress reduction was an effective adjunct to medical therapy in women with angina and no obstructive coronary artery disease, a small pilot study indicated.
A standard 8-week Kabat-Zinn mindfulness-based stress reduction training course resulted in significant reductions in angina frequency and severity, as well as in self-reported depression, anxiety, and perceived stress, compared with medical therapy alone in the crossover study, Dr. Vedant Pargaonkar reported at the annual meeting of the American College of Cardiology.
The mindfulness training did not, however, produce any significant effect on vascular function or levels of the inflammatory biomarkers interleukin-6 and C-reactive protein, added Dr. Pargaonkar of Stanford (Calif.) University.
Mindfulness training has been successfully employed in a variety of patient populations to improve quality of life and emotional resilience. Dutch investigators recently reported promising results in patients who underwent percutaneous coronary intervention (J. Behav. Med. 2014;37:135-44).
Dr. Pargaonkar presented a prospective study involving 19 women, mean age 53 years, with angina triggered by emotional stress. All participants had undergone coronary angiography, which uniformly showed no obstructive coronary artery disease. Participants were randomized to receive either the 8-week mindfulness-based stress reduction course plus standard anti-anginal medications or medications alone while being wait-listed for the mindfulness training.
Patients underwent a battery of tests at baseline, again after 8 weeks, and in the control group a third time once they completed the 8-week mindfulness course. The testing included the Seattle Angina Questionnaire, the Beck Depression Inventory-II, the State-Trait Anxiety Scale, the Perceived Stress Scale, Rosenberg’s Self-Esteem Scale, the Kentucky Inventory of Mindfulness Skills, the SF-36, peripheral vascular function assessment via flow-mediated dilation testing, and measurement of systemic inflammatory biomarkers.
Eight weeks of wait-list control didn’t result in any significant changes from baseline on any measures. However, after women completed the structured mindfulness-based stress reduction program, they experienced a significant reduction in angina frequency, from three or more times per week to one to two. Their physical limitations due to angina improved from moderate to slight, or from slight at baseline to none.
They also demonstrated significant reductions in their scores on the validated measures of depression, anxiety, and perceived stress, as well as significant improvement on the Kentucky Mindfulness Scale. Most of the improvements were in the absolute 10%-15% range.
Dr. Pargaonkar observed that the major limitations of his pilot study are the small sample size and the lack of follow-up to assess the durability of the benefits.
The study was conducted free of commercial support. Dr. Pargaonkar reported having no financial conflicts.
