title: Mind-body practices for patients with cardiac disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Due to new treatment modalities in the last decades, a decline in cardiovascular deaths has been observed. There is an emerging field of secondary prevention and behavioural programmes with increased interest in the use of mind-body practices. Until now, these have not been established in cardiovascular disease treatment programmes.
  
  
  METHODS
  We performed a systematic review and meta-analysis of the available evidence on the effectiveness of mind-body practices for patients with diagnosed cardiac disease.
  
  
  METHODS
  We included randomized controlled trials (RCTs), published in English, reporting mind-body practices for patients with diagnosed cardiac disease. EMBASE, MEDLINE, Pubmed, Web of Science, The Cochrane Central Register of Controlled Trials and PsycINFO were searched up to July 2013. Two reviewers independently identified studies for inclusion and extracted data on study characteristics, outcomes (Quality of Life, anxiety, depression, physical parameters and exercise tolerance) and quality assessment. Standardized effect sizes (Cohen's d) were calculated comparing the outcomes between the intervention and control group and random effects meta-analysis was conducted.
  
  
  RESULTS
  We identified 11 unique RCTs with an overall low quality. The studies evaluated mindfulness-based stress reduction, transcendental meditation, progressive muscle relaxation and stress management. Pooled analyses revealed effect sizes of 0.45 (95%CI 0.20-0.72) for physical quality of life, 0.68 (95%CI 0.10-1.26) for mental quality of life, 0.61 (95%CI 0.23-0.99) for depression, 0.52 (95%CI 0.26-0.78) for anxiety, 0.48 (95%CI 0.27-0.69) for systolic blood pressure and 0.36 (95%CI 0.15-0.57) for diastolic blood pressure.
  
  
  CONCLUSIONS
  Mind-body practices have encouraging results for patients with cardiac disease. Our review demonstrates the need for high-quality studies in this field.
authors.affiliation: Department of Cardiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: John O
authors.initials: JO
authors.lastname: Younge
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Rinske A
authors.initials: RA
authors.lastname: Gotink
authors.affiliation: School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Baena
authors.affiliation: Department of Cardiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA m.hunink@erasmusmc.nl.
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D017079:Exercise Tolerance; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000379:methods*; D011788:Quality of Life; D020127:Recovery of Function; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D016896:Treatment Outcome
keywords: Meditation; cardiovascular disease; mind–body; psychosocial risk factors; secondary prevention; systematic review