Abstract P1025: Overall Effect of Stress Reduction Interventions on Cardiovascular Outcomes (Both Qualitative and Quantitative): A Systematic Review and Meta-Analysis.

Abstract

Background: Cardiovascular diseases (CVDs) are a leading cause of global mortality, with chronic stress being a significant risk factor. This review examines the effectiveness of stress reduction interventions (SRIs) on cardiovascular health outcomes in adults. Methods: A systematic literature search was conducted using PubMed, Cochrane Library, ERIC, and Google Scholar between 2015 and 2024 for the effect of SRIs on various CVDs. A random-effects model was used to analyse data for mean difference (MD) and 95% CI using Review Manager software 5.4.1 version. SRIs like cognitive behavioural therapy (CBT), Yoga, mindfulness-based stress reduction (MBSR), heart rate variability biofeedback (HRV-BF), Tai-Chi, Mindful Awareness Practices (MAP), and coping skills training (CST) were examined in various CVDs like CHF, CAD, MI and HTN. The RoB 2 tool, funnel plots were used for quality assessment and publication bias respectively. Heterogeneity was determined by I 2 statistics and leave one out analysis study. A P-value <0.05 was considered significant. Results: A total of 14 studies were included with 1,180 participants and a mean age of 54.64 years. Qualitative outcomes such as quality of life (QoL), health related quality of life (HRQL), heart rate variability (HRV), left ventricular ejection fraction (LVEF), NTproBNP, cognitive functions, and hostility reduction were systematically reviewed. Quantitative outcomes including systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), C-reactive protein (CRP), and high frequency power (HFP) which reflects the changes in heart rate with respiration were subjected to statistical analysis. SRIs significantly lowered SBP [MD = −9.70 mmHg, 95% CI (−14.39, −5.01), p < 0.0001] and DBP [MD = −5.52 mmHg, 95% CI (−10.57, −0.47), p < 0.0001] respectively but did not significantly affect HR (MD = −0.01 bpm, 95% CI [−2.87, 2.86], p = 0.17) or CRP levels (MD = 0.58 mg/L, p = 0.70) or HFP (MD = 4.22 ms^2, p = 0.92) [Image 1]. Additionally, yoga was associated with reduced levels of CRP, NTproBNP and improved QoL, LVEF. Tai chi was linked to enhanced cognitive function, and QoL while MAP and MBSR lowered perceived stress and anger levels [Image 2]. Conclusion: SRIs are associated with lower SBP, DBP pressure, heart rate, CRP levels, HFP levels, and improvement in qualitative outcomes. Larger prospective studies are required to assess these outcomes to improve preventive measures and decrease cardiac mortality.