Psychological stress management interventions reduced all-cause mortality by 37% in patients with coronary artery disease, according to a recent review. 

The systematic review and meta-analysis assessed the effect of nonpharmacological psychological interventions for stress management on major adverse cardiovascular events (MACE) and mortality in patients with coronary artery disease (CAD). This analysis included seven randomized clinical trials with a combined sample of 1,908 patients, evaluating MACE outcomes—defined as cardiovascular mortality, nonfatal infarction, revascularization, nonfatal stroke, and cardiovascular hospitalization—as the primary endpoint. Secondary outcomes focused on all-cause mortality.

Results, published in the International Journal of Stress Management, demonstrated no statistically significant effect of stress management interventions on MACE reduction (34.54% vs. 39.05%; risk ratio [RR], 0.84; 95% confidence interval [CI], 0.63,1.12; P = .24; I² = 74.7%), indicating high heterogeneity across studies. However, a 37% reduction in all-cause mortality was observed among patients receiving psychological interventions compared to controls (8.58% vs. 13.62%; RR, 0.63; 95% CI, 0.42,0.95; P = .03; I² = 23.8%), with low heterogeneity.

The included stress management programs employed cognitive-behavioral strategies, relaxation training, and self-monitoring, primarily in group settings, with some studies utilizing individual or mixed delivery modes. Interventions aimed to mitigate stress-related responses in CAD patients without pharmacologic support.

While this review found no significant association between psychological interventions and MACE reduction, the observed reduction in mortality suggests a potential link to improved survival outcomes with nonpharmacologic stress management. Further studies are needed to explore which specific program components may be associated with this effect.

Full disclosures can be found in the published review.