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Treatment of anxiety in patients with coronary heart disease: Rationale and design of the UNderstanding the benefits of exercise and escitalopram in anxious patients WIth coroNary heart Disease (UNWIND) randomized clinical trial.

Publication ,  Journal Article
Blumenthal, JA; Feger, BJ; Smith, PJ; Watkins, LL; Jiang, W; Davidson, J; Hoffman, BM; Ashworth, M; Mabe, SK; Babyak, MA; Kraus, WE ...
Published in: Am Heart J
June 2016

BACKGROUND: Anxiety is highly prevalent among patients with coronary heart disease (CHD), and there is growing evidence that high levels of anxiety are associated with worse prognosis. However, few studies have evaluated the efficacy of treating anxiety in CHD patients for reducing symptoms and improving clinical outcomes. Exercise and selective serotonin reuptake inhibitors have been shown to be effective in treating patients with depression, but have not been studied in cardiac patients with high anxiety. METHODS: The UNWIND trial is a randomized clinical trial of patients with CHD who are at increased risk for adverse events because of comorbid anxiety. One hundred fifty participants with CHD and elevated anxiety symptoms and/or with a diagnosed anxiety disorder will be randomly assigned to 12 weeks of aerobic exercise (3×/wk, 35 min, 70%-85% VO2peak), escitalopram (5-20 mg qd), or placebo. Before and after 12 weeks of treatment, participants will undergo assessments of anxiety symptoms and CHD biomarkers of risk, including measures of inflammation, lipids, hemoglobin A1c, heart rate variability, and vascular endothelial function. Primary outcomes include post-intervention effects on symptoms of anxiety and CHD biomarkers. Secondary outcomes include clinical outcomes (cardiovascular hospitalizations and all-cause death) and measures of quality of life. CONCLUSIONS: The UNWIND trial (ClinicalTrials.gov NCT02516332) will evaluate the efficacy of aerobic exercise and escitalopram for improving anxiety symptoms and reducing risk for adverse clinical events in anxious CHD patients.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

June 2016

Volume

176

Start / End Page

53 / 62

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Selective Serotonin Reuptake Inhibitors
  • Psychological Techniques
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans
  • Heart Rate
  • Glycated Hemoglobin
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Blumenthal, J. A., Feger, B. J., Smith, P. J., Watkins, L. L., Jiang, W., Davidson, J., … Sherwood, A. (2016). Treatment of anxiety in patients with coronary heart disease: Rationale and design of the UNderstanding the benefits of exercise and escitalopram in anxious patients WIth coroNary heart Disease (UNWIND) randomized clinical trial. Am Heart J, 176, 53–62. https://doi.org/10.1016/j.ahj.2016.03.003
Blumenthal, James A., Bryan J. Feger, Patrick J. Smith, Lana L. Watkins, Wei Jiang, Jonathan Davidson, Benson M. Hoffman, et al. “Treatment of anxiety in patients with coronary heart disease: Rationale and design of the UNderstanding the benefits of exercise and escitalopram in anxious patients WIth coroNary heart Disease (UNWIND) randomized clinical trial.Am Heart J 176 (June 2016): 53–62. https://doi.org/10.1016/j.ahj.2016.03.003.
Blumenthal JA, Feger BJ, Smith PJ, Watkins LL, Jiang W, Davidson J, Hoffman BM, Ashworth M, Mabe SK, Babyak MA, Kraus WE, Hinderliter A, Sherwood A. Treatment of anxiety in patients with coronary heart disease: Rationale and design of the UNderstanding the benefits of exercise and escitalopram in anxious patients WIth coroNary heart Disease (UNWIND) randomized clinical trial. Am Heart J. 2016 Jun;176:53–62.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

June 2016

Volume

176

Start / End Page

53 / 62

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Selective Serotonin Reuptake Inhibitors
  • Psychological Techniques
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Humans
  • Heart Rate
  • Glycated Hemoglobin
  • Female