Risk factors for myocardial infarction: the importance of relaxation

Psychophysiological effects of cardiac rehabilitation in post-myocardial infarction patients

Psychophysiological reactivity and cardiovascular functioning were assessed in 40 patients with coronary heart disease before and after taking part in either a Type A modification training program or a control condition. Treated patients showed an overall attenuated heart rate (HR) response and prolonged diastolic time to mental stress performance, during recovery and rest periods, as compared lo control patients. No other measure, including impedance-cardiography-derived measures, differentiated the two groups. The treatment group showed reduction from before lo after treatment in 24-hr minimum IIR level and decreased frequencies of premature ventricular contractions, whereas the control group showed an opposite trend. Results from an exercise test suggested the same direction for resting IIR and double-product levels. The two groups did not differ in maximal systolic and diastolic blood pressure or in maximal double-product levels, despite a differential development, in favor of the treatment group, in maximal work capacity.

Assessing adaptive and maladaptive coping in the early phase of acute myocardial infarction

We assessed retrospectively symptom management behaviors among 45 patients with acute myocardial infarction (AMI). Cluster analysis was conducted on data from the Structured Interview (SI), in order to group patients according to the global TABP, Anger-In, Potential for Hostility, and a newly derived measure of Behavioral Compensation for Stress (BEH-COMP). Two groups were identified. MALADAPT SI-copers (N = 24) had higher scores on Anger-In and Hostility and lower scores on BEH-COMP in comparison to the ADAPT SI-copers (N = 21), while no difference was observed on TABP. The SI groups were next compared on AMI symptom management behaviors. A hierarchical discriminant analysis found that the MALADAPT group reported greater distraction from AMI symptoms, were relief-seeking behavior, and greater perceived vulnerability to reinfarction. AMI coping behaviors correlated meaningfully with delay in seeking medical assistance. Further research is warranted, given the potential for using the ADAPT/MALADAPT SI-profiles to predict adjustment to AMI.