Abstract 887: A Brief Relaxation Response Intervention Lowers Capillary Blood Glucose Levels in Patients Hospitalized With Coronary Artery Disease
Activation of the neuroendocrine response to stress results in numerous physiologic changes that can have untoward effects on glucose levels and hemodynamic status, especially in patients hospitalized with CAD. It is posited that therapies designed to counteract the stress response might be effective in promoting better patient outcomes, however no study has been conducted that examines the effect of a relaxation response intervention on physiologic markers of stress to include blood glucose in patients hospitalized with CAD. To test the hypothesis that the relaxation response may modulate the stress response and improve blood glucose levels, an experimental study was designed to test the effect of a brief, nurse-delivered relaxation response intervention on capillary blood glucose (CBG), heart rate (HR), blood pressure (BP) and rate-pressure product (RPP) in patients hospitalized with CAD. In this randomized clinical trial, subjects (N=48; 75% male; age 64.6 +/− 10.4 yrs) were assigned to either the experimental or control group. Pretest measures of CBG, HR, BP and RPP were obtained for all subjects. Subjects in the experimental group were taught to elicit the relaxation response and asked to practice the technique for 20 minutes. Subjects in the control group were instructed to rest quietly for 20 minutes. Posttest measures of CBG, HR, BP and RPP were obtained for all subjects following the 20 minute study period. Multivariate analysis of covariance demonstrated a significant difference in adjusted mean scores between the experimental and control group (p=.002). Follow-up univariate analyses of covariance demonstrated significant decreases in CBG (p=.008), HR (p=.024) and RPP (p=.044) in the group receiving the relaxation response intervention. The findings indicated that in patients hospitalized with CAD, a brief, nurse-delivered relaxation response intervention was more effective in lowing capillary blood glucose, heart rate and rate pressure product than a usual care approach. Thus, a brief, nurse-delivered relaxation response intervention may prove a novel method for hemodynamic and metabolic modulation of the stress response to include the prevention and treatment of stress-induced hyperglycemia among patients hospitalized with CAD.