| REVIEW ARTICLE |
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| Year : 2020 | Volume
: 4
| Issue : 4 | Page : 109-115 |
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Novel comprehensive cardiac rehabilitation to combat the dose-dependent relationship between psychosocial stress and cardiovascular disease
Evan L OKeefe1, Carl J Lavie2, Sergey M Kachur3
1 Department of Internal Medicine, Tulane Medical Center, New Orleans, LA, USA
2 Department of Internal Medicine, Tulane Medical Center; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA
3 Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA
Correspondence Address:
Dr. Carl J Lavie
John Ochsner Heart and Vascular Institute, 1514 Jefferson Highway, New Orleans, LA 70121 2483
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/hm.hm_32_20
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The association of cardiovascular disease (CVD) and psychosocial stress (PSS) is a bidirectional function, whereby the two conditions create a self-reinforcing feedback loop. Either can incite and/or magnify the other, prognosis consequently deteriorates and spontaneous remission is unlikely. Several studies show that even subclinical PSS increases mortality. Recent evidence suggests that stress exhibits a strong dose–response toxicity on cardiovascular health with increased levels of PSS directly correlating to additional morbidity and mortality. As such, it will be important that future research considers PSS as a continuous variable capable of causing a spectrum of disease. This article proposes targeted exercise routines as the most efficient therapy for both arms of the feedback loop. A consistent body of data indicates that regular physical activity eases the PSS burden while simultaneously lowering CVD risk. Exercise therapy, mindfulness training, and interventions targeting positive psychological well-being stress management are indispensable therapies, particularly for at-risk and already established cardiovascular patients. Indeed, comprehensive cardiac rehabilitation and exercise training programs inclusive of education, lifestyle, and psychological measures in addition to fitness training are a potent multifaceted therapy for improving quality of life and overall prognosis.
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