Spiritual retreat can lower depression, raise hope in heart patients

ScienceDaily (Aug. 1, 2011) — Attending a non-denominational spiritual retreat can help patients with severe heart trouble feel less depressed and more hopeful about the future, a University of Michigan Health System study has found.

Heart patients who participated in a four-day retreat that included techniques such as meditation, guided imagery, drumming, journal writing and outdoor activities saw immediate improvement in tests measuring depression and hopefulness. Those improvements persisted at three- and six-month follow-up measurements.

The study was the first randomized clinical trial to demonstrate an intervention that raises hope in patients with acute coronary syndrome, a condition that includes chest pain and heart attack. Previous research has shown that hope and its opposite, hopelessness, have an impact on how patients face uncertain futures.

"The study shows that a spiritual retreat like the Medicine for the Earth program can jumpstart and help to maintain a return to psycho-spiritual well-being," says study lead author Sara Warber, M.D., associate professor of family medicine at the U-M Medical School and director of U-M's Integrative Medicine program. "These types of interventions may be of particular interest to patients who do not want to take antidepressants for the depression symptoms that often accompany coronary heart disease and heart attack."

The findings were published in the July issue of Explore: the Journal of Science and Healing.

The retreat group was compared to two other groups: one received standard cardiac care and the other participated in a lifestyle change retreat run by the U-M Cardiovascular Center that focused on nutrition, physical exercise and stress management.

The spiritual retreat portion of the study was conducted at the Windrise Retreat Center in Metamora, Michigan, about 50 miles north of Detroit. In the Medicine for the Earth program, participants are encouraged to see themselves as part of an interconnected web of life. The approach is founded on the work of co-author Sandra Ingerman, M.A., who wrote the book Medicine for the Earth: How to Transform Personal and Environmental Toxins, which emphasizes principles of love, harmony, beauty, unity and peace.

The study used a number of standard mental and physical benchmarks to assess the success of the program.

The spiritual retreat group went from a baseline score of 12 on the Beck Depression Inventory, indicating mild to moderate depression, to an improved score of 6 immediately afterward, a 50-percent reduction. Their scores remained that low half a year later. The lifestyle group saw their scores drop from 11 to 7 and remain there. The control group's score started at 8 and went down to 6.

Participants also showed marked improvement in their scores on a test measuring hope. Scores on the State Hope Scale can range from 6 to 48, with higher scores indicating greater hope. All three study groups started with average scores between 34 and 36. After the spiritual retreat, participants' average scores rose and stayed at 40 or above, while the other two groups' averages remained significantly lower, ranging from 35 to 38, three and six months later.

"Our work adds an important spiritual voice to the current discussion of the importance of psychological well-being for patients facing serious medical issues, such as acute coronary artery disease," Warber says.

Citation: "Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients," Explore: The Journal of Science and Healing, July 2011.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Michigan Health System, via EurekAlert!, a service of AAAS.

Journal Reference:

Sara Warber et al. Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients. Explore: the Journal of Science and Healing, 2011

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Predictors of dying suddenly versus surviving heart attack identified

ScienceDaily (July 26, 2011) — Is it possible to predict whether someone is likely to survive or die suddenly from a heart attack? A new study by researchers at Wake Forest Baptist Medical Center has answered just that.

"For some people, the first heart attack is more likely to be their last," said Elsayed Z. Soliman, M.D., M.Sc., M.S., director of the Epidemiological Cardiology Research Center (EPICARE) at Wake Forest Baptist and lead author of the study. "For these people especially, it is important that we find ways to prevent that first heart attack from ever happening because their chances of living through it are not as good."

While there are many traits that are common among heart attack patients -- both those who survive the event and those who die suddenly -- researchers found that some traits, such as hypertension, race/ethnicity, body mass index (BMI), heart rate, and additional markers that can be identified by an electrocardiogram (ECG) can differentiate between dying suddenly versus living through a heart attack, Soliman said.

The study, published by the journal Heart, is now available online.

Somewhere between 230,000 and 325,000 people in the U.S. succumb to sudden cardiac death every year, Soliman said. Most of these sudden deaths are caused by coronary heart disease.

"Since sudden cardiac death usually occurs before patients ever make it to the hospital, there is very little that can be done to save them," Soliman said. "Identifying specific predictors that separate the risk of sudden cardiac death from that of non-fatal or not immediately fatal heart attacks would be the first step to address this problem, which was the basis for our study."

Researchers analyzed data from two of the largest U.S. cardiovascular studies -- the ARIC (Atherosclerosis Risk in Communities) and the CHS (Cardiovascular Health Study) -- containing records for more than 18,000 participants. After taking into account common risk factors for coronary heart disease and the competing risk of sudden cardiac death with coronary heart disease, they found that:

Black race/ethnicity (compared to non-black) was predictive of high sudden cardiac death risk, but less risk of coronary heart disease.Hypertension and increased heart rate were stronger predictors of high risk of sudden cardiac death compared to coronary heart disease.Extreme high or low body mass index was predictive of increased risk of sudden cardiac death but not of coronary heart disease.Additional, more technical traits that a doctor evaluating an ECG report could use to evaluate risk of sudden cardiac death in their patients. (Prolongation of QTc and abnormally inverted T wave were stronger predictors of high risk of sudden cardiac death. On the other hand, elevated electrocardiographic ST height in V2 was not predictive of sudden cardiac death but predictive of coronary heart disease.)

If the results are validated and confirmed in other studies, Soliman predicts that doctors will have a way to identify patients who are at greater risk of dying suddenly if they experience a heart attack and, therefore, a group of patients for whom early intervention, including risk factor modification, may be a life-saving option.

"Our next step in this path of research is to see if we can come up with a risk stratification score that can be applied to the general population, as well as to look at interventions that reverse the effect that these traits are having on susceptibility to sudden cardiac death," Soliman said. "We need to know if lowering hypertension, BMI or resting heart rate would reduce the risk of dying suddenly."

The study was funded by the Donald W. Reynolds Cardiovascular Clinical Research Center at the Johns Hopkins University School of Medicine. The ARIC and CHS studies are supported by the National Heart, Lung, and Blood Institute.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wake Forest Baptist Medical Center, via EurekAlert!, a service of AAAS.

Journal Reference:

E. Z. Soliman, R. J. Prineas, L. D. Case, G. Russell, W. Rosamond, T. Rea, N. Sotoodehnia, W. S. Post, D. Siscovick, B. M. Psaty, G. L. Burke. Electrocardiographic and clinical predictors separating atherosclerotic sudden cardiac death from incident coronary heart disease. Heart, 2011; DOI: 10.1136/hrt.2010.215871

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here