Highly stressed patients with ischemic heart disease do not respond as well to medications for their condition as do patients with lower levels of psychological distress, a new study by Canadian scientists shows. Patients with high levels of daily stress showed less than average reduction in episodes of ischemia and severe heart pains (angina), and showed less improvement in performance on a treadmill.
Scientists at the University of British Columbia and Ottawa Heart Institute examined 80 participants during a 12-week study of the benefits of anti-ischemic medications (atenolol and amlodipine).
"Psychological factors can undermine a patient's responsiveness to medication," said Thomas Rutledge, PhD, of the University of British Columbia, lead author of the study. "Our results suggest that these psychological factors may have as great a negative impact on recovery from disease as they do on developing disease."
While the medical treatment produced highly significant benefits for all of the participants, higher levels of stress resulted in lower effectiveness of treatment. Although 40 percent of all participants reported angina after treatment, almost 90 percent of the more highly stressed patients did so. While patients overall showed an average of 5.5 fewer ischemic episodes after treatment, the more highly stressed persons averaged an improvement of only 4.4 fewer episodes.
The researchers said the results show the importance of psychological factors not only in producing illness but also in the treatment for illness. They report the results of their study in the November/December issue of Psychosomatic Medicine.