EFFECTIVENESS OF DEEP BREATHING EXERCISE (DBE) ON THE HEART RATE VARIABILITY, BP, ANXIETY & DEPRESSION OF PATIENTS WITH CORONARY ARTERY DISEASE

Abstract

Abstract:Psychosocial risk factors significantly contribute to the morbidity and mortality of patients with cardiovascular disorders. The present study explored the anxiety and depression status of patients with coronary artery disease and evaluated the effect of deep breathing exercise on these psychosocial variables as well as physiological variables like heart rate variability and blood pressure. A randomized control design was adopted for the study. Out of 65 clients eligible for the study, 45 were selected based on inclusion criteria. Patient were trained in Deep breathing exercise (DBE)for 2-3 days, were instructed to practice the exercise twice a day for 10 min for a period of 2 weeks, further instructed to come for follow up to cardiac OPD after 2 weeks. The study findings revealed that majority of the cardiac patients were anxious 39 (86.66%), 23(57.5%) had mild depression and 3(7.5%) were with severe depression. Fischer's exact test revealed a significant association between depression and occupation (p=0.051), monthly income (p=0.031) and co morbid disease (p=0.006, p<0.05). Karl Pearson's correlation coefficient revealed significant positive correlation between anxiety and depression i.e. (r = 0.414, p <0.01). DBE was found to be effective in reducing anxiety and diastolic BP of clients with CAD. But there was no significant reduction in HR, SBP and depression after the intervention.

Treatment of Anxiety in Patients With Coronary Heart Disease: A Systematic Review

“…For the majority of studies (93 studies, out of 119), the inclusion criteria did not specifically include a psychiatric diagnosis of an anxiety disorder. Of the remaining 26 studies, 4 included elevated anxiety in their inclusion criteria (30, 31, 39, 43), 9 included patients with anxiety and/or depression (44-52), 8 included patients with depression, depressive symptoms, or mood disorder only (36, 37, 40, 53-57), 3 included patients with ‘distress’ (10, 58, 59), one included patients with “psychosomatic symptoms” including restlessness, anxiety, altered mood, and insomnia (60), and another included patients with “exhaustion” (61).…”

“…The kinds of relaxation therapies were varied: two studies involved deep breathing interventions (44, 80); four examined autogenic training, alone (81, 82) or combined with cardiac coherence biofeedback (83) or EMG feedback (84); two used muscle relaxation therapy (85) (one also included guided imagery (86)); two used mindfulness-based interventions (64, 67); one used a music tape during aerobic exercise compared to similar exercise without music (87); one used guided imagery compared to a music tape during exercise (88); and one gave participants their choice of relaxation therapy (e.g., yoga, mindfulness) (89). Another study compared a group receiving progressive muscle relaxation instruction with another receiving mindfulness-based meditation instruction (57).…”

“…In terms of efficacy of the interventions that prominently featured relaxation, 6 resulted in a greater reduction in anxiety for the intervention group compared to a control group (44, 64, 80-82, 85) and the remaining 8 studies reported a nonsignificant difference in anxiety between treatment groups.…”

“…In another CR study, Oldridge et al compared weekly exercise for 8 weeks to a usual care control group, and anxiety improved for patients in the intervention group with elevated anxiety scores at baseline compared to controls (51). D'Silva et al compared a 2-week deep breathing intervention to a usual care control group for patients with anxious or depressive symptoms, and reported that anxiety scores were lower in the experimental group (44).…”

Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry

“…Deep breathing exercise was found to be effective in reducing anxiety and diastolic BP of patients with coronary artery disease than patients without slow and deep breathing exercise. [8]…”