title: Mind-Body Medicine in the Secondary Prevention of Coronary Heart Disease.
abstract: BACKGROUND
  In mind-body medicine (MBM), conventional lifestyle modification measures such as dietary counseling and exercise are supplemented with relaxation techniques and psychological motivational elements. This review studied the effect of MBM on cardiac events and mortality in patients with coronary heart disease (CHD).
  
  
  METHODS
  This review is based on publications up to and including January 2015 that were retrieved by a systematic search in PubMed, the Cochrane Library, and Scopus. Randomized controlled trials of the effect of MBM programs (versus standard treatment) on cardiac events, overall mortality, and/or cardiac mortality were analyzed. Atherosclerosis, blood pressure, LDL cholesterol, and the body mass index (BMI) were chosen as secondary outcomes. Random-effects meta-analyses were performed. The risk of bias was assessed with the Cochrane tool.
  
  
  RESULTS
  Twelve trials, performed on a total of 1085 patients, were included in the analysis. Significant differences between groups were found with respect to cardiac events (odds ratio [OR]: 0.38; 95% confidence interval [CI]: 0.23-0.61; p<0.01; heterogeneity [I2]: 0%), but not overall mortality (OR: 0.82; 95% CI: 0.46-1.45; p = 0.49; I2: 0%) or cardiac mortality (OR: 0.98; 95% CI: 0.43-2.25; p = 0.97; I2: 0%). Significant differences between groups were also found with respect to atherosclerosis (mean difference [MD] = -7.86% diameter stenosis; 95% CI: -15.06-[-0.65]; p = 0.03; I2: 0%) and systolic blood pressure (MD = -3.33 mm Hg; 95% CI: -5.76-[-0.91]; p<0.01; I2: 0%), but not with respect to diastolic blood pressure, LDL cholesterol, or BMI.
  
  
  CONCLUSIONS
  In patients with CHD, MBM programs can lessen the occurrence of cardiac events, reduce atherosclerosis, and lower systolic blood pressure, but they do not reduce mortality. They can be used as a complement to conventional rehabilitation programs.
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Department of Internal and Complementary Medicine, Immanuel Hospital, Berlin, Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin, Berlin.
authors.forename: Holger
authors.initials: H
authors.lastname: Cramer
authors.forename: Romy
authors.initials: R
authors.lastname: Lauche
authors.forename: Anna
authors.initials: A
authors.lastname: Paul
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*; D004035:Diet Therapy / Q000401:mortality / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D026441:Mind-Body Therapies / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data*; D012064:Relaxation Therapy / Q000401:mortality / Q000706:statistics & numerical data; D055502:Secondary Prevention / Q000379:methods / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome