title: Optimal healing environments for chronic cardiovascular disease.
abstract: A substantial increase in chronic cardiovascular disease is projected for the next several decades. This is attributable to an aging population and accelerated rates of obesity and diabetes. Despite technological advances that have improved survival for acute events, there is suboptimal translation of research knowledge for prevention and treatment of chronic cardiovascular illness. Beginning with a brief review of the demographics and pathogenesis of atherosclerotic cardiovascular disease, this paper discusses the obstacles and approaches to optimal care of patients with chronic cardiovascular disease. The novel concept of an optimal healing environment (OHE) is defined and explored as a model for integrative cardiac health care. Aspects generally underexamined in cardiac care such as intrapersonal/interpersonal characteristics of the health care provider and patient, mind/body/spirit wholeness and healing versus curing are discussed, as is the impact psychosocial factors may have on atherosclerosis and cardiovascular health. Information from research on the impact of an OHE might renew the healing mission in medicine, reveal new approaches for healing the heart and establish the importance of a heart-mind-body connection.
authors.affiliation: Coronary Artery Disease Reversal Program, Walter Reed Army Medical Center, Washington, DC 20307, USA. Debra.Marshall@na.amedd.army.mil
authors.forename: Debra A
authors.initials: DA
authors.lastname: Marshall
authors.forename: Elaine
authors.initials: E
authors.lastname: Walizer
authors.forename: Marina N
authors.initials: MN
authors.lastname: Vernalis
mesh_terms: D001161:Arteriosclerosis / Q000517:prevention & control; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002908:Chronic Disease; D015438:Health Behavior; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D008019:Life Style; D019222:Mind-Body Relations, Metaphysical; D010353:Patient Education as Topic / Q000592:standards*; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D011368:Professional-Family Relations; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care; D020377:Self Efficacy; D014481:United States / Q000453:epidemiology