The best formula for living well with heart disease incorporates some combination of heart medications (like anticoagulant medications, beta-blockers, anti-lipid or cholesterol-lowering medicines), regular medical check-ups, and a rehabilitation regimen that includes modifying risk factors. Regarding risk factors, it is especially important to get moderate exercise, eat a heart-healthy diet, and if you smoke, stop…right now!

But if you want to really increase the odds that you will live a long and happy life with heart disease, you must add one more piece to the rehabilitation puzzle: get help to learn how to cope with this illness. According to the Task Force of the Working Group on Cardiac Rehabilitation of the European Society of Cardiology, patients who learn how to cope with the emotional and relationship challenges that come with heart disease live longer (and happier) lives than those who simply exercise and take medications.

Put another way, exercise and good nutrition are necessary but not sufficient for thriving with heart disease. For example, exercise alone does not lead to sustained changes in anxiety, depression, or confidence in one’s ability to live a full life with heart illness, nor does it change family/marital dynamics. But when you combine exercise training with some form of stress management training, quality of life improves significantly. Overall, research with heart patients has shown that learning to cope leads to improvements in self-confidence in the short-term, lessened levels of tension, anxiety, and depression, and increased vigor and fewer cardiac symptoms (less invalid behavior), and improved adherence to medication recommendations.

A recent analysis from studies that had evaluated 2024 patients who received psychological treatment versus 1156 patients who received standard care showed just how life-saving it can be when heart patients learn to cope (Linden, 1996). The psychologically-treated patients showed greater reductions in psychological distress, systolic blood pressure, heart rate, and cholesterol levels. Those who received psychological care also had a 41% reduction in death from cardiac-related causes and 46% reduction in death rates from non-fatal cardiac causes during the first 2 years of follow-up. And at longer-term follow-up, learning to cope lead to a 39% reduction in death rates compared to heart patients who did not receive psychological care.

So if you want the “Cadillac” of cardiac care, seek regular medical input and follow your doctors’ advice; take your medications; manage your lifestyle; join a cardiac rehabilitation program; and get help to learn how to cope with your emotions and your family relationships.

For further information, see:
-Linden W, Stossel C, Maurice J. Psychosocial interventions for patients with coronary artery disease. Arch Intern Med. 1996;156:745-752.
-Task Force of the Working Group on Cardiac Rehabilitation of the European Society of Cardiology. Risk of poor quality of life. Eurpean Heart J. 1992; 13(suppl C):20-34.

This article was adapted from information presented more fully in Thriving With Heart Disease, by W. Sotile with R Cantor-Cook. New York: The Free Press, 2003. Copyright W. Sotile, 2003. All rights reserved.

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