Psychosocial Issues in Cardiac Rehabilitation 7 A Regional Psychology Service for Cardiac Patients Enrolled In Cardiac Rehabilitation

There is a growing body of research indicating that it is important to include psychological interventions in cardiac rehabilitation (CR). Negative emotional states such as stress, anxiety, depression and anger have been linked to pathophysiologic processes associated with the development and progression of cardiovascular disease.1-3 They have been shown to have a direct impact on traditional cardiac risk factors and pathologic precursors such as decreased heart rate variability, impaired hemodynamic recovery and increased platelet aggre-gation. They also have an indirect influence on these factors via their link to unhealthy lifestyle patterns and poor adherence to treatment recommendations. Moreover, negative emotions have been associated with an increased risk of experiencing an initial or a recurrent cardiac event as well as cardiac death.4-6 This increase in risk often follows a dose-dependent relationship. A significant number of cardiac patients experienc