In patients at risk for cardiovascular events who are under increased psycho-social stress, a stress management program can be considered as part of an overall preventive strategy. 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 physiological 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 physiological 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 bio-feedback, 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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