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Home-based secondary prevention programs may help reduce anxiety in individuals with coronary artery disease.

McClure T, Haykowsky MJ, Schopflocher D et al.  Home-based secondary prevention programs for patients with coronary artery disease: A meta-analysis of effects on anxiety  J Cardiopulm Rehabil Prev. 2013; 33(2):59-67

Review question

Do home-based prevention programs lower anxiety among individuals with coronary heart disease?


Many people with coronary heart disease experience anxiety, which can affect their quality of life and daily living.  Secondary prevention programs (such as rehabilitation) can improve life expectancy, quality of life and heart disease risk factors in patients with coronary heart disease, but little is known about whether these programs help to ease patient anxiety.  This review focused on home-based programs, since patients are more likely to participate at home, rather than at centre-based programs.

How the review was done

This is a summary of 8 single studies, which included a total of 3011 participants ranging in age from 56 to 67 years). One study included only women; the majority of participants in the other studies were men (60 – 82%).

The studies used anxiety measurement tools to assess whether home-based secondary prevention programs affected the anxiety levels of people with established heart disease.  All of the programs were led by nurses with special training in cardiac disease.  The quality of included studies was moderate to low.

What the researchers found

Home-based secondary prevention programs were associated with small reductions in anxiety compared to usual care or centre-based cardiac rehabilitation.  The most effective programs provided manuals or other printed material about risk factors and guidance on health promotion practices (exercise, diet, and psychosocial well-being), as well as follow-up phone calls or home visits from a health professional.  Since women and men may have different psychological needs, it would be helpful for future studies to examine whether gender makes a difference in how people respond to this type of support.


Comprehensive cardiac rehabilitation programs delivered in the home may help reduce anxiety among individuals with heart disease.  


Coronary heart disease
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
Risk factors
Aspects making a condition more likely.

Related Web Resources

  • Coronary artery disease risk screening

    Health Link B.C.
    Men over 40 and women past menopause or over 50 should get screened for coronary artery disease (CAD) every 1 to 3 years. Your risk is higher if you have diabetes, high blood pressure, abdominal obesity, kidney disease, family history of CAD or if you smoke.
  • High cholesterol: Does reducing the amount of fat in your diet help?

    Informed Health Online
    Eat less saturated fats in your diet to help prevent heart disease. Eat less meat, butter, cheese and cream to improve your health long-term.
  • Statins: Should I Take Them to Prevent a Heart Attack or Stroke?

    This patient decision aid helps people considering taking medicines called statins to lower their risk of heart attack and stroke by comparing the benefits, risks, and side effects of both options. It also includes alternative treatment options to taking statins such as trying to lower risk with lifestyle changes.
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