Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis

Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-...

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Bibliographic Details
Published in:Journal of behavioral medicine 2024-06, Vol.47 (3), p.374-388
Main Authors: Gathright, Emily C., Hughes, Joel W., Sun, Shufang, Storlazzi, Laurie E., DeCosta, Julie, Balletto, Brittany L., Carey, Michael P., Scott-Sheldon, Lori A. J., Salmoirago-Blotcher, Elena
Format: Article
Language:English
Subjects:
Adults
Biofeedback
Cardiovascular disease
Cardiovascular diseases
Clinical trials
Family Medicine
Feedback
General Practice
Health Psychology
Heart rate
Intervention
Medicine
Medicine & Public Health
Meta-analysis
Quasi-experimental methods
Random effects
Stress management
Systematic review
Variability
Women
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Summary:Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, M age : 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV ( d + = .27, 95% confidence interval [CI] 0.01–0.52, k  = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV ( d + = 0.31, 95% CI 0.09–0.53, k  = 7, Q [6] = 3.82, p  = .70, I 2  = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.
ISSN:0160-7715
1573-3521
1573-3521
DOI:10.1007/s10865-024-00468-4