Background Methods Results

• Cardiac rehabilitation (CR) is a professionally A randomized, controlled, repeated-measures design supervised program to help people recover from -Data collected at baseline, 4 weeks, 8 weeks, 12 weeks • Preliminary findings indicate that cardiovascular events. and 24 weeks participants increased in positive affect over • Recruited from two phase II CR programs in Southeastern NC time and decreased in anger control CR programs provide education and counseling to Inclusion criteria: Age 18 or older, read, write and speak regardless of group help patients increase physical fitness, reduce cardiac English and able to give consent • There were no differences in anger in/anger symptoms, improve health and reduce the risk of Exclusion criteria: Diagnosis of thought disorder, bipolar out , but there was a trend suggesting future heart problems (AHA, 2015). disorder, borderline personality disorder, or illicit increases in both over time substance abuse/dependence; already practice • There were no differences for perceived Holistic modalities, such as mindfulness, that mindfulness or other types of meditation, or who stress or anxiety. integrate mind/body approaches have the potential attended 4 classes in such practices within the past; to improve outcomes as well as help one to calm the visual, hearing or cognitive impairments mind and body (Casey et al., 2009). Recent studies indicate that the use of such practices is promising in Intervention: Received 8, one hour weekly mindfulness sessions, helping CR participants to cope with stress, anxiety asked to practice 20 minutes daily at home and record practice, and depression (Casey et al., 2009; Nyklíček et al., also received mindfulness book & MP3 player with guided 2014, Parswani et al., 2013). meditations Control: Treatment as usual Conclusion Additionally, there is evidence to suggest that mindfulness also positively affects physiological To avoid contamination groups were not run concurrently; Fidelity outcomes such as blood pressure, body mass index was maintained by using one interventionalist for all training (BMI) and hemoglobin A1c (HgbA1c) levels • Preliminary results suggest positive trends in (Hartmann et al., 2012; Hughes et al., 2010; Parswani the data. Larger more diverse sample is et al., 2013. needed and will require a multi-site study Results that includes larger CR programs However, few CR programs offer these practices (AHA, 2015) • Participation in CR alone may affect the mind • Between April 2016 and June 2017 28 participants body connection Abbott and colleagues (2014) in a systematic review recruited into the study; 10 completed through week with meta-analysis recommend further studies with 8, 7 completed through week 24 in the intervention • Mindfulness is a feasible intervention to longer follow up to firmly establish the benefits. group, 9 completed through week 8 and 9 finished implement in CR through week 24 • 26 cases analyzed with multilevel modeling using • Attrition was a factor in this longitudinal maximum likelihood estimation study, with unique issues impacting participation: ill spouses, other Demographic Data commitments (work, doctor’s appointments, Purpose Variable Mindfulness Control travel), comfort with intervention Intervention

The purpose of this pilot study was to: Age () 67.6 years 70 years • Lessons learned Gender: Male 4 (40%) 5 (50%) -Offer training at multiple times in • assess the effectiveness of a mindfulness Gender: Female 6 (60%) 5 (50%) intervention compared to a non- Educational Level (% total) conjunction with CR class intervention, control group (treatment as High school diploma 40% 30% -Quiet designated space is essential usual) on physiological (blood pressure, BMI Community college 20% 30% Baccalaureate degree 30% 40% • Individuals in the intervention group & program completion) and psychosocial Graduate degree 10% 0 outcomes (anger, depression, anxiety, heart Marital Status expressed wanting ongoing training and disease health related quality of life, affect, Married 90% 80% refreshers Divorced 0 10% & perceived stress) in a sample of cardiac Widowed 10% 10% rehabilitation participants Race Caucasian 100% 100% Income level (% total) ` • determine the feasibility of the intervention $25,001-$50,000 50% 30% and plan $50,0001-$75,000 20% 20% $75,001-$100,000 10% 40% > $100,000 20% 10% Number of RX medications Mean () 7.8 (2-12) 5.1 (2-9) A Number of OTC or Supplemental 4.1 (0-9) 4.5 (0-8) medications Mean (range) References Years with heart disease Mean (range) 62.25 months (1.5- 50.88 months 264) (2-192)

Abbott, R., Whear, R., Rodgers, L., Bethel, A., Coon, J.T., Kuyken, W., Stein, K., & Dickens, C. (2014). Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 76, 341-351. American Heart Association (2015). What is cardiac rehabilitation? Retrieved 9/5/2015 from http://www.heart.org/HEARTORG/Conditions/More/CardiacRehab/What-is-Cardiac Rehabilitation_UCM_307049_Article.jsp Casey, A. Chang, BH., Huddleston, J., Virani, N., Benson, H., & Dusek, J. (2009). A model for Integrating a mind/body approach to cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 29, 230-238. Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., …Nawroth, P. (2012). Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients. Diabetes Care, 35, 945-947. Hughes, J., Fresco, D. Myerscough, R., van Dulmen, H., Carlson, L., Josephson, R. (2013). Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosomatic Medicine, 75, 721-728. Nyklíček,I., Dijksman, S., Lenders, P., Fonteijn, W., & Koolen, J. (2014). A brief mindfulness intervention for increase in emotional well-being and quality of life in percutaneous coronary intervention (PCI) patients: The mindfulheart randomized Acknowledgements: This study was funded by a controlled trial. Journal of Behavioral Medicine, 37, 135-144. Parswani, M., Sharma, M., & Iyengar SS. (2013). Mindfulness-based stress reduction Charles Cahill Award; we thank the RA’s Natalie program in coronary heart disease: A randomized control trial. International Journal Swiger, Martina Mirabito and Ann Weatherby, of Yoga, 6, 111-117. the administrators for allowing us access and all those who participated.