Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation.

The science of cardiac rehabilitation and the secondary prevention of cardiovascular disease has progressed substantially since the most recent American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation update on the core components of cardiac rehabilitation and secondary prevention programs was published in 2007. In addition, the advent of new care models, including virtual and remote delivery of cardiac rehabilitation services, has expanded the ways that cardiac rehabilitation programs can reach patients. In this scientific statement, we update the scientific basis of the core components of patient assessment, nutritional counseling, weight management and body composition, cardiovascular disease and risk factor management, psychosocial management, aerobic exercise training, strength training, and physical activity counseling.

Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis.

Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included.

Mindfulness-Based Interventions for Patients with Cardiovascular Disease: A Focused Review for Practicing Clinicians.

Purpose Of Review: With growing scientific and public interest in the health benefits of mindfulness, clinicians increasingly face questions and solicitations for advice from patients about the efficacy of mindfulness-based interventions (MBIs) for cardiovascular disease (CVD). In this clinician-focused review, we aim to revisit empirical studies on MBIs for CVD with the purpose of informing clinicians' decisions on how to provide recommendations consistent with updated scientific findings to patients interested in MBIs.

Recent Findings: We start by defining MBIs and identifying the possible physiological, psychological, behavioral, and cognitive mechanisms underlying the potentially positive effects of MBIs for CVD.

Mind Your Heart-II: Protocol for a behavioral randomized controlled trial of mindfulness training to promote self-care in patients with comorbid heart failure and cognitive impairment.

Background: Heart failure (HF) self-care is a robust predictor of prognosis in HF patients. Cognitive impairment is a common comorbidity in HF patients and constitutes a major challenge to HF self-care. Mindfulness training (MT) has been shown to improve cognitive function and interoception, two components essential to promoting effective HF self-care.

Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality: A SYSTEMATIZED REVIEW, META-ANALYSIS, AND CASE FOR PREVENTION.

Background: Psychological distress-elevated symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), or psychosocial stress-has been associated with risk for cardiovascular disease (CVD). Despite increasing attention to the importance of these factors for CVD prevention, the state of this science requires updated synthesis to enable practice recommendations. Moreover, it is unknown whether psychological distress based on screeners, validated self-report instruments that efficiently identify those who may require mental health services or additional support, is associated with incident CVD.

Meta-Analysis of Antidepressant Pharmacotherapy in Patients Eligible for Cardiac Rehabilitation: ANTIDEPRESSANT AMBIVALENCE.

Purpose: Many patients exhibit clinically significant depression upon enrollment in cardiac rehabilitation (CR). Antidepressants are a first-line treatment option for depression, but the effectiveness of antidepressants in patients with heart disease is mixed. The purpose of this meta-analysis was to evaluate the efficacy of antidepressants for depression in patients eligible for CR.

The development and pilot testing of a behavioral activation-based treatment for depressed mood and multiple health behavior change in patients with recent acute coronary syndrome.

Background: Patients with acute coronary syndrome (ACS) with depressed mood demonstrate poor cardiovascular behavioral risk profiles and elevated risk for recurrent ACS and mortality. Behavioral Activation (BA) offers an intervention framework for an integrated treatment targeting both depression and critical health behaviors post-ACS. Behavioral Activation for Health and Depression (BA-HD) was developed and pilot tested in a multiphase iterative process.

Stress management interventions for adults with heart failure: Systematic review and meta-analysis.

Objective: Stress management interventions (SMIs) targeting psychological stress and other psychosocial factors associated with heart failure (HF) morbidity and mortality are increasingly recommended for adults with HF. SMI content and delivery varies widely and meta-analyses are needed to synthesize current findings to identify gaps in the literature. The purpose of this meta-analysis is to examine the efficacy of SMIs for improving anxiety, depressive symptoms, exercise capacity, and disease-specific quality of life in adults with HF.

Health Literacy, Cognitive Function, and Mortality in Patients With Heart Failure.

Background: Health literacy has predicted mortality in heart failure. However, the role of cognitive functioning in this relationship has not been evaluated. We hypothesized that health literacy would predict all-cause mortality but that cognitive functioning would modify the relationship between health literacy and mortality in heart failure.

Women's participation in stress management interventions for chronic heart failure: a meta-analysis of randomized controlled trials.

Stress management interventions (SMIs) can alleviate the psychosocial stress often experienced by women with heart failure. The purpose of this meta-analysis was to summarize women's participation rates, and predictors of participation, in SMIs for the management of psychosocial distress in women with chronic HF. Studies were retrieved from bibliographic databases, reference sections of relevant papers, and research registries.

Important Personal Values of Veterans Enrolled in Home-Based Cardiac Rehabilitation.

Background: Home-based cardiac rehabilitation (CR) heavily relies on patients' personal motivation to engage in behavior change. Patients' core values (e.g.

Complementary and integrative health approaches to manage chronic pain in U.S. military populations: Results from a systematic review and meta-analysis, 1985-2019.

The objective of this study was to examine the efficacy of complementary and integrative health (CIH) approaches for reducing pain intensity (primary outcome) and depressive symptoms (secondary outcome) as well as improving physical functioning (secondary outcome) among U.S. military personnel living with chronic pain.

Electronic cigarette use among heart failure patients: Findings from the Population Assessment of Tobacco and Health study (Wave 1: 2013-2014).

Background: Smoking cessation is recommended for adults with heart failure (HF). The prevalence of e-cigarette use among adults with HF is unknown.

Objective: To determine prevalence of and reasons for e-cigarette use among adults with HF.

The impact of transcendental meditation on depressive symptoms and blood pressure in adults with cardiovascular disease: A systematic review and meta-analysis.

Background: Transcendental Meditation (TM) as a stress management technique may offer an adjunctive strategy to improve health and well-being in adults with cardiovascular disease (CVD).

Objectives: To examine the efficacy of TM to improve aspects of cardiovascular health and psychological functioning in adults with CVD.

Method: Studies (a) evaluating TM in adults with hypertension or CVD and (b) assessing a physiological or psychological outcome were retrieved and meta-analyzed.

Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.

Background: The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis.

Mindfulness-Based Interventions for Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis.

Background: Individuals with cardiovascular disease (CVD) report psychological distress and poor physical functioning and may benefit from mindfulness training.

Purpose: To examine the effects of mindfulness-based interventions (MBIs) on psychological and physiological measures in adults with CVD using meta-analysis.

Methods: Comprehensive searches identified studies that (a) evaluated MBIs in adults with CVD or who had experienced a cardiac event, (b) included a comparison condition, and (c) assessed psychological (e.

Feasibility of a Bike-Share Program in Adults With Serious Mental Illness Enrolled in an Outpatient Psychiatric Rehabilitation Program.

: Individuals with serious mental illness (SMI) die 10-25 years earlier than the general population, partially due to cardiovascular disease. Those with SMI have poor cardiovascular disease behavioral risk profiles, including low physical activity engagement. This study examined the feasibility of providing city bike-share access to individuals with SMI.

Improvements in Depressive Symptoms and Affect During Cardiac Rehabilitation: PREDICTORS AND POTENTIAL MECHANISMS.

Purpose: Depression is indicative of poor prognosis in cardiac patients. Reductions in depression have been observed following cardiac rehabilitation (CR). Whether similar improvements in positive and negative affect occur is unknown.

Examination of clinical and psychosocial determinants of exercise capacity change in cardiac rehabilitation.

Purpose: Most cardiac rehabilitation (CR) completers improve in multiple functional and psychosocial domains. However, not all demonstrate uniform improvement in functional indicators such as exercise capacity. This study examined baseline predictors and correlates of change in exercise capacity from CR intake to completion.

The impact of medication nonadherence on the relationship between mortality risk and depression in heart failure.

Objective: Heart failure affects more than 5 million U.S. adults, and approximately 20% of individuals with heart failure experience depressive symptoms.

Internal health locus of control predicts willingness to track health behaviors online and with smartphone applications.

Given rising technology use across all demographic groups, digital interventions offer a potential strategy for increasing access to health information and care. Research is lacking on identifying individual differences that impact willingness to use digital interventions, which may affect patient engagement. Health locus of control, the amount of control an individual believes they have over their own health, may predict willingness to use mobile health (mHealth) applications ('apps') and online trackers.

Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team.

Many individuals with cardiovascular disease (CVD) experience depression that is associated with poor health outcomes, which may be because of medication nonadherence. Several factors influence medication adherence and likely influence the relationship between depression and medication adherence in CVD patients. This comprehensive study reviews the existing literature on depression and medication adherence in CVD patients, addresses the methods of and problems with measuring medication adherence, and explains why the integrated care team is uniquely situated to improve the outcomes in depressed CVD patients.

Depressive symptoms moderate the relationship between medication regimen complexity and objectively measured medication adherence in adults with heart failure.

Patients with heart failure (HF) take many medications to manage their HF and comorbidities, and 20-50% experience depression. Depressed individuals with more complex medication regimens may be at greater risk for poor adherence. The aim of this study was to assess depressive symptoms as a moderator of the relationship between medication regimen complexity and medication adherence in an observational study of patients with HF.

Depression increases the risk of mortality in patients with heart failure: A meta-analysis.

Background: Depression is a risk factor for mortality in cardiovascular diseases. Prior studies confirm that depression predicts adverse outcomes in patients with heart failure (HF). However, data were inconclusive regarding the effect of depression on mortality.