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Exercise to Reduce Distress and Improve Cardiac Function: Moving on and Finding the Pace

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Abstract

There is now clear scientific evidence linking regular aerobic physical activity to a significant cardiovascular risk reduction, and a sedentary lifestyle is currently ­considered one of the major risk factors for cardiovascular disease. Several behavioral profiles, including depression, hostility, anxiety, and overall psychosocial stress, are prevalent in patients with coronary artery disease and have been shown to independently confirm a high risk for subsequent myocardial infarction and death. It has been demonstrated that exercise training during cardiac rehabilitation can markedly reduce these high-risk behaviors. Exercise also reduces the psychophysiological response to psychological stress. Therefore, exercise has become an important ­component of stress management in conjunction with, and as a supplement to psychological counseling.

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References

  1. Physical Activity and Cardiovascular Health. NIH consensus development panel on physical activity and cardiovascular health. JAMA. 1996;276:241-246.

    Article  Google Scholar 

  2. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402-407.

    Article  PubMed  CAS  Google Scholar 

  3. US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.

    Google Scholar 

  4. Myers J. Exercise and cardiovascular health. Circulation. 2003;107:e2-e5.

    Article  PubMed  Google Scholar 

  5. Lee I-Min, Skerret PJ. Physical activity and all-cause mortality: what is the dose-response ­relation? Med Sci Sports Exerc. 2001;33:S459-S471.

    Article  PubMed  CAS  Google Scholar 

  6. Fagard RH. Physical exercise and coronary artery disease. Acta Cardiol. 2002;57:91-100.

    Article  PubMed  Google Scholar 

  7. Thompson PD, Buchner D, Piña IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. A Statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation. 2003;107:3109-3116.

    Article  PubMed  Google Scholar 

  8. Williams PT. Physical fitness and activity as separate heart disease risk factors: a meta-­analysis. Med Sci Sports Exerc. 2001;33:754-761.

    PubMed  CAS  Google Scholar 

  9. Blair SN, Cheng Y, Holder JS. Is physical activity or physical fitness more important in ­defining health benefits? Med Sci Sports Exerc. 2001;33:S379-S399.

    Article  PubMed  CAS  Google Scholar 

  10. Myers J, Prakash M, Froelicher V, et al. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793-801.

    Article  PubMed  Google Scholar 

  11. ACSM position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975-991.

    Google Scholar 

  12. Fletcher GF, Balady GJ, Amsterdam EA, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694-1740.

    Article  PubMed  CAS  Google Scholar 

  13. Durstine JL, Painter P, Franklin BA, et al. Physical activity for the chronically ill and disabled. Sports Med. 2000;30:207-219.

    Article  PubMed  CAS  Google Scholar 

  14. Franklin BA, Kahn JK. Delayed progression or regression of coronary atherosclerosis with intensive risk factors modification. Effects of diet, drugs, and exercise. Sports Med. 1996;22:306-320.

    Article  PubMed  CAS  Google Scholar 

  15. Billman GE. Aerobic exercise conditioning: a non-pharmacological antiarrhythmic intervention. J Appl Physiol. 2002;92:446-454.

    PubMed  Google Scholar 

  16. Hambrecht R, Wolf A, Gielen S, et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med. 2000;342:454-460.

    Article  PubMed  CAS  Google Scholar 

  17. Wenger NK, Froelicher ES, Smith LK, et al. Cardiac Rehabilitation. Clinical Practice Guideline No. 17. Rockville: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute. AHCPR Publication No. 96-0672. October 1995.

    Google Scholar 

  18. American Association of Cardiovascular & Pulmonary Rehabilitation. Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs. 3rd ed. Champaign: Human Kinetics; 1999.

    Google Scholar 

  19. Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001;345:892-902.

    Article  PubMed  CAS  Google Scholar 

  20. Williams MA, Fleg JL, Ades PA, et al. Secondary prevention of coronary heart disease in the elderly (with emphasis on patients Z75 years of age). An American Heart Association scientific statement from the council on clinical cardiology subcommittee on exercise, cardiac rehabilitation, and prevention. Circulation. 2002;105:1735-1743.

    Article  PubMed  Google Scholar 

  21. Piepoli MF, Corrá U, Benzer W et al. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil. 2010;17:1-17.

    Article  PubMed  CAS  Google Scholar 

  22. Jolliffe JA, Rees K, Taylor RS, et al. Exercise-based rehabilitation for coronary heart disease (Cochrane review). In: The Cochrane Library, vol. 1. Oxford: Update Software; 2003.

    Google Scholar 

  23. Mittleman MA, Maclure M, Sherwood JB, et al. Triggering of acute myocardial infarction onset by episodes of anger. Determinants of myocardial infarction onset study investigators. Circulation. 1995;92:1720-1725.

    Article  PubMed  CAS  Google Scholar 

  24. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. JAMA. 1993;270:1819-1825.

    Article  PubMed  CAS  Google Scholar 

  25. American College of Sports Medicine. Guidelines for Exercise Testing and Prescription. 6th ed. Baltimore: Lippincott Williams & Wilkins; 2000.

    Google Scholar 

  26. Rozanski A, Blumenthal JA, Davidson KW, et al. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol. 2005;45:637-651.

    Article  PubMed  Google Scholar 

  27. Frasure-Smith N, Lesperance F, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995;91:999-1005.

    Article  PubMed  CAS  Google Scholar 

  28. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:2192-2217.

    Article  PubMed  CAS  Google Scholar 

  29. Rumsfeld JS, Ho PM. Depression and cardiovascular disease: a call for recognition. Circulation. 2005;111:250-253.

    Article  PubMed  Google Scholar 

  30. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937-952.

    Article  PubMed  Google Scholar 

  31. Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case control study. Lancet. 2004;364:953-962.

    Article  PubMed  Google Scholar 

  32. Blumenthal JA, Lett HS, Babyak MA, et al. Depression as a risk factor for mortality after ­coronary artery bypass surgery. Lancet. 2003;362:604-609.

    Article  PubMed  Google Scholar 

  33. Carney RM, Blumenthal JA, Catellier D, et al. Depression as a risk factor for mortality after acute myocardial infarction. Am J Cardiol. 2003;92:1277-1281.

    Article  PubMed  Google Scholar 

  34. Milani RV, Littman AB, Lavie CJ. Psychological adaptation to cardiovascular disease. In: Messerli FH, ed. Cardiovascular Disease in the Elderly. 3rd ed. Boston: Kluwer; 1993:401-412.

    Chapter  Google Scholar 

  35. Koskenvuo M, Kaprio J, Rose RJ, et al. Hostility as a risk factor for mortality and ischemic heart disease in men. Psychosom Med. 1988;50:330-340.

    PubMed  CAS  Google Scholar 

  36. Dembroski TM, MacDougall JM, Costa PT Jr, Grandits GA. Components of hostility as predictors of sudden death and myocardial infarction in the multiple risk factor intervention trial. Psychosom Med. 1989;51:514-522.

    PubMed  CAS  Google Scholar 

  37. Kawachi I, Sparrow D, Spiro A 3rd, et al. A prospective study of anger and coronary heart disease. The normative aging study. Circulation. 1996;94:2090-2095.

    Article  PubMed  CAS  Google Scholar 

  38. Kawachi I, Sparrow D, Kubzansky LD, et al. Prospective study of a self-report type a scale and risk of coronary heart disease: test of the MMPI-2 type a scale. Circulation. 1998;98:405-412.

    Article  PubMed  CAS  Google Scholar 

  39. Allison TG, Williams DE, Miller TD, et al. Medical and economic costs of psychologic distress in patients with coronary artery disease. Mayo Clin Proc. 1995;70:734-742.

    Article  PubMed  CAS  Google Scholar 

  40. Frasure-Smith N, Lesperance F, Juneau M. Differential long-term impact of in-hospital symptoms of psychological stress after non-Q wave and Q-wave acute myocardial infarction. Am J Cardiol. 1992;69:1128-1134.

    Article  PubMed  CAS  Google Scholar 

  41. Bjorntorp P. Stress and cardiovascular disease. Acta Physiol Scand Suppl. 1997;640:144-148.

    PubMed  CAS  Google Scholar 

  42. Shibeshi WA, Young-Xu Y, Blatt CM. Anxiety worsens prognosis in patients with coronary artery disease. J Am Coll Cardiol. 2007;49:2021-2027.

    Article  PubMed  Google Scholar 

  43. Thorne LC, Bartholomew JB, Craig J, Farrar RP. Stress reactivity in fire fighters: an exercise intervention. Int J Stress Manag. 2000;7:235-246.

    Article  Google Scholar 

  44. Bond DS, Lyle RM, Tappe MK, Seehafer RS, D’Zurilla J. Moderate aerobic exercise, t’ai chi, and social problem-solving ability in relation to psychological stress. Int J Stress Manag. 2002;9:329-343.

    Article  Google Scholar 

  45. Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a ­unifying theory. Clin Psychol Rev. 2001;21:33-61.

    Article  PubMed  CAS  Google Scholar 

  46. Linden W. Stress Management. From Basic Science to Better Practice. London: Sage; 2005.

    Google Scholar 

  47. Hescham S, Grace L, Kellaway LA, Bugarith K, Russell VA. Effect of exercise on synaptophysin and calcium/calmodulin-dependent protein kinase levels in prefrontal cortex and hippocampus of a rat model of developmental stress. Metab Brain Dis. 2009;24:701-709.

    Article  PubMed  CAS  Google Scholar 

  48. Gerber M, Puhse U. Review article: do exercise and fitness protect against stress-induced health complaints? A review of the literature. Scand J Public Health. 2009;37:801-819.

    Article  PubMed  Google Scholar 

  49. Hautanen A, Adlercreutz H. Altered adrenocorticotropin and cortisol secretion in abdominal obesity: implications for the insulin resistance syndrome. J Intern Med. 1993;234:461-469.

    Article  PubMed  CAS  Google Scholar 

  50. Rosmond R, Dallman MF, Bjorntorp P. Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab. 1998;83:1853-1859.

    Article  PubMed  CAS  Google Scholar 

  51. Deuster PA, Petrides JS, Singh A, Lucci EB, Chrousos GP, Gold PW. High intensity exercise promotes escape of adrenocorticotropin and cortisol from suppression by dexamethasone: sexually dimorphic responses. J Clin Endocrinol Metab. 1998;83:3332-3338.

    Article  PubMed  CAS  Google Scholar 

  52. Kjaer M. Regulation of hormonal and metabolic responses during exercise in humans. Exerc Sport Sci Rev. 1992;20:161-184.

    PubMed  CAS  Google Scholar 

  53. Luger A, Deuster PA, Kyle SB, et al. Acute hypothalamic–pituitary–adrenal responses to the stress of treadmill exercise. Physiologic adaptations to physical training. N Engl J Med. 1987;316:1309-1315.

    Article  PubMed  CAS  Google Scholar 

  54. Korkushko OV, Frolkis MV, Shatilo VB. Reaction of pituitary–adrenal and autonomic nervous systems to stress in trained and untrained elderly people. J Auton Nerv Syst. 1995;54:27-32.

    Article  PubMed  CAS  Google Scholar 

  55. Blaney J, Sothmann M, Raff H, Hart B, Horn T. Impact of exercise training on plasma ­adrenocorticotropin response to a well-learned vigilance task. Psychoneuroendocrinology. 1990;15:453-462.

    Article  PubMed  CAS  Google Scholar 

  56. Sinyor D, Schwartz SG, Peronnet F, Brisson G, Seraganian P. Aerobic fitness level and ­reactivity to psychosocial stress: physiological, biochemical, and subjective measures. Psychosom Med. 1983;45:205-217.

    PubMed  CAS  Google Scholar 

  57. Sothmann MS, Gustafson AB, Garthwaite TL, Horn TS, Hart BA. Cardiovascular fitness and selected adrenal hormone responses to cognitive stress. Endocr Res. 1988;14:59-69.

    Article  PubMed  CAS  Google Scholar 

  58. Boutcher SH, Nurhayati Y, McLaren PF. Cardiovascular response of trained and untrained old men to mental challenge. Med Sci Sports Exerc. 2001;33:659-664.

    PubMed  CAS  Google Scholar 

  59. de Geus EJ, van Doornen LJ, Orlebeke JF. Regular exercise and aerobic fitness in relation to psychological make-up and physiological stress reactivity. Psychosom Med. 1993;55:347-363.

    PubMed  Google Scholar 

  60. Summers H, Lustyk MK, Heitkemper M, Jarrett ME. Effect of aerobic fitness on the ­physiological stress response in women. Biol Res Nurs. 1999;1:48-56.

    Article  PubMed  CAS  Google Scholar 

  61. Blumenthal JA, Sherwood A, Babyak MA, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a ­randomized controlled trial. JAMA. 2005;293:1626-1634.

    Article  PubMed  CAS  Google Scholar 

  62. Eriksen HR, Ihlebaek C, Mikkelsen A, Gronningsaeter H, Sandal GM, Ursin H. Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme. Occup Med (Lond). 2002;52:383-391.

    Article  CAS  Google Scholar 

  63. Schonert-Hirz S. Meine Stressbalance. Rezepte für Vielbeschäftigte von Dr. Stress. Frankfurt: Campus Verlag; 2006.

    Google Scholar 

  64. Milani RV, Lavie CJ. Reducing psychosocial stress: a novel mechanism of improving survival from exercise training. Am J Med. 2009;122:931-938.

    Article  PubMed  Google Scholar 

  65. Rozanski A, Blumenthal J. Cardiac rehabilitation, exercise training, and psychosocial risk ­factors: REPLY. J Am Coll Cardiol. 2005;47:212-213.

    Article  Google Scholar 

  66. Heather SL, Davidson J, Blumenthal JA. Nonpharmacologic treatments for depression in patients with coronary heart disease. Psychosom Med. 2005;67:58-62.

    Article  Google Scholar 

  67. Blumenthal JA, Babyak MA, Doraiswamy PM, et al. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med. 2007;69:587-596.

    Article  PubMed  CAS  Google Scholar 

  68. Martens EJ, Hoen PW, Mittelhaeuser M, de Jonge P, Denollet J. Symptom dimensions of ­post-myocardial infarction depression, disease severity and cardiac prognosis. Psychol Med. 2010;40:1-8.

    Article  Google Scholar 

  69. Milani RV, Lavie CJ. Impact of cardiac rehabilitation on depression and its associated ­mortality. Am J Med. 2007;120:799-806.

    Article  PubMed  Google Scholar 

  70. Milani RV, Lavie CJ, Cassidy MM. Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events. Am Heart J. 1996;132:726-732.

    Article  PubMed  CAS  Google Scholar 

  71. Lavie CJ, Milani RV. Effects of cardiac rehabilitation programs on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in a large elderly cohort. Am J Cardiol. 1995;76:177-179.

    Article  PubMed  CAS  Google Scholar 

  72. Lavie CJ, Milani RV. Prevalence of anxiety in coronary patients with improvement following cardiac rehabilitation and exercise training. Am J Cardiol. 2004;93:336-339.

    Article  PubMed  Google Scholar 

  73. Lavie CJ, Milani RV. Prevalence of hostility in young coronary artery disease patients and effects of cardiac rehabilitation and exercise training. Mayo Clin Proc. 2005;80:335-342.

    Article  PubMed  Google Scholar 

  74. Lucini D, Milani RV, Costantino G, et al. Effects of cardiac rehabilitation and exercise training on autonomic regulation in patients with coronary artery disease. Am Heart J. 2002;143:977-983.

    Article  PubMed  Google Scholar 

  75. Milani RV, Lavie CJ, Mehra MR. Reduction in C-reactive protein through cardiac rehabilitation and exercise training. J Am Coll Cardiol. 2004;43:1056-1061.

    Article  PubMed  CAS  Google Scholar 

  76. Milani RV, Lavie CJ. Prevalence and profile of metabolic syndrome in patients following acute coronary events and effects of therapeutic lifestyle change with cardiac rehabilitation. Am J Cardiol. 2003;92:50-54.

    Article  PubMed  Google Scholar 

  77. Giannuzzi P, Saner H, Björnstad H, et al. Secondary prevention through cardiac rehabilitation: position paper of the working group on cardiac rehabilitation and exercise physiology of the European Society of Cardiology. Eur Heart J. 2003;24:1273-1278.

    Article  PubMed  CAS  Google Scholar 

  78. Balady GJ, Williams M, Ades PA, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. A scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2007;115:2675-2682.

    Article  PubMed  Google Scholar 

  79. World Health Organization. Rehabilitation after Cardiovascular Diseases, with Special Emphasis on Developing Countries. Report of a WHO Expert Committee, WHO Technical Report Series, No. 831. 1993; Geneva: World Health Organization.

    Google Scholar 

  80. Piepoli MF, Corra U, Benzer W, et al. Review. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. EJCPR. 2010;17:1-17.

    Google Scholar 

  81. Jordan J, Barde B, Zeiher AM. Contributions Toward Evidence-Based Psychocardiology: A Systematic Review of the Literature. Washington DC: American Psychological Association; 2007.

    Book  Google Scholar 

  82. Linden W. Psychological treatments in cardiac rehabilitation: review of rationales and ­outcomes. J Psychosom Res. 2000;48:443-454.

    Article  PubMed  CAS  Google Scholar 

  83. American Association of Cardiovascular and Pulmonary Rehabilitation. Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs. Champaign: Human Kinetics; 2004.

    Google Scholar 

  84. Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction: combined experience of randomized clinical trials. JAMA. 1988;260:945-950.

    Article  PubMed  CAS  Google Scholar 

  85. Linden W, Stossel C, Maurice J. Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med. 1996;156:745-752.

    Article  PubMed  CAS  Google Scholar 

  86. Dusseldorp E, van Elderen T, Maes S, Meulman J, Kraaij V. A meta-analysis of psychoeducational programs for coronary heart disease patients. Health Psychol. 1999;18:506-519.

    Article  PubMed  CAS  Google Scholar 

  87. Rees K, Bennett P, West R, Davey SG, Ebrahim S. Psychological interventions for coronary heart disease. Cochrane Database Syst Rev. 2004;2:CD002902002E.

    Google Scholar 

  88. van Dixhoorn J, White A. Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2005;12:193-202.

    Article  PubMed  Google Scholar 

  89. Clark AM, Hartling L, Vandermeer B, McAlister FA. Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143:659-672.

    Article  PubMed  Google Scholar 

  90. Linden W, Phillips MJ, Leclerc J. Psychological treatment of cardiac patients: a meta-analysis. Eur Heart J. 2007;28:2972-2984.

    Article  PubMed  Google Scholar 

  91. Frasure-Smith N, Lesperance F, Prince RH, et al. Randomised trial of home-based psychosocial nursing intervention for patients recovering from myocardial infarction. Lancet. 1997;16(350):473-479.

    Article  Google Scholar 

  92. Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289:3106-3116.

    Article  PubMed  Google Scholar 

  93. Friedman M, Thoresen CE, Gill JJ, et al. Alteration of type A behavior and its effect on cardiac recurrences in post myocardial infarction patients: summary results of the recurrent coronary prevention project. Am Heart J. 1986;112:653-665.

    Article  PubMed  CAS  Google Scholar 

  94. Gulliksson, M. Studies of Secondary Prevention after Coronary Heart Disease with Special Reference to Determinants of Recurrent Event Rate. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 472, 2009;ISSN 1651-6206.

    Google Scholar 

  95. Sirur R, Richardson J, Wishart L, Hanna S. The role of theory in increasing adherence to ­prescribed practice. Physiother Can. 2009;61:68-77.

    Article  PubMed  Google Scholar 

  96. Furze G, Lewin RJ, Murberg T, Bull P, Thompson DR. Does it matter what patients think? The relationship between changes in patients’ beliefs about angina and their psychological and functional status. J Psychosom Res. 2005;59:323-329.

    Article  PubMed  Google Scholar 

  97. Maeland JG, Havik OE. Psychological predictors for return to work after a myocardial ­infarction. J Psychosom Res. 1987;31:471-481.

    Article  PubMed  CAS  Google Scholar 

  98. Maeland JG, Havik OE. Use of health services after a myocardial infarction. Scand J Soc Med. 1989;17:93-102.

    PubMed  CAS  Google Scholar 

  99. Goulding L, Furze G, Birks Y. Randomized controlled trials of interventions to change ­maladaptive illness beliefs in people with coronary heart disease: systematic review. J Adv Nurs. 2010;66:946-961.

    Article  PubMed  Google Scholar 

  100. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:143-164.

    Article  PubMed  Google Scholar 

  101. Fernandez RS, Davidson P, Griffiths R, Juergens C, Salamonson Y. Development of a health-related lifestyle self-management intervention for patients with coronary heart disease. Heart Lung. 2009;38:491-498.

    Article  PubMed  Google Scholar 

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Saner, H., Burell, G. (2011). Exercise to Reduce Distress and Improve Cardiac Function: Moving on and Finding the Pace. In: Hjemdahl, P., Steptoe, A., Rosengren, A. (eds) Stress and Cardiovascular Disease. Springer, London. https://doi.org/10.1007/978-1-84882-419-5_18

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