Recent evidence increasingly supports the connection between psychological factors and the development of coronary artery disease (CAD), particularly in relation to stress and anxiety. These emotional states can elevate catecholamine and cortisol levels, potentially resulting in cardiac damage (1). Employing a holistic treatment approach that addresses the entire individual may offer greater efficacy, especially when stress and anxiety are significant contributors.
Integrative medicine emphasizes comprehensive care by addressing emotional, spiritual, psychological, and physical needs. This approach combines evidence-based medical treatments with complementary therapies to support the individual as a whole, rather than focusing solely on a specific organ or disease.
A large study by Janszky et al. found that early-onset anxiety, as defined by ICD-8 criteria, was linked to a higher risk of coronary artery disease in a group of 49,321 Swedish men followed for 37 years (2). Mindfulness-based interventions have also been shown to reduce stress and anxiety in healthcare workers and patients with non-cardiac chest pain (3). In a randomized controlled trial, Mittal et al. found that mindfulness-based cognitive interventions led to significant improvements in anxiety, chest pain scores, and how often symptoms occurred (4).
Taken together, these findings underscore the significance of incorporating integrative, holistic strategies such as mindfulness and stress reduction in the prevention and management of coronary artery disease.
References
Rakel D. Integrative Medicine. Chapter 26: Coronary Artery Disease. p. 253–263.
Janszky I, et al. Early onset of depression, anxiety, and risk of subsequent coronary artery disease. J Am Coll Cardiol 2010;56(1).
Ameli R, PhD, et al. Effect of a brief mindfulness-based program on stress in healthcare professionals at a U.S. biomedical research hospital: a randomized controlled trial. JAMA Netw Open. 2020;3(8):e2013424.
Mittal TK, et al. Mindfulness-based intervention in patients with persistent chest pain of non-cardiac cause (MIPIC): a feasibility randomized controlled study. Open Heart. 2022;E001970.