Psychological interventions in cardiovascular disease.

The literature on the behavioural treatment of primary hypertension, reduction of Type A behaviour, and psychological interventions during acute coronary care and rehabilitation after a myocardial infarction are selectively reviewed. There is growing evidence that relaxation and stress management can lower blood pressure by useful amounts in mild primary hypertension although the mechanisms underlying these reductions are unclear. Type A behaviour has been reduced in patients following a myocardial infarction and this led to reduced morbidity. Other interventions following myocardial infarction, both when the patient is in hospital and after discharge have produced at best only modest benefits and are, therefore, not widely applicable. Future research in rehabilitation should be directed at reducing the disabilities of patients with clearly identifiable problems that stem from their response to cardiovascular disease.