Promoting wellness in cardiac rehabilitation: exploring the role of altruism.

Coronary artery disease continues to be the primary cause of mortality in the United States. Recent studies have significantly advanced the ability to improve outcomes in this disorder by demonstrating that intensive risk factor modification programs with diet, lipid-lowering drugs, exercise, and psychosocial interventions can reverse atherosclerosis and reduce events by 40% to 60%. Of all the interventional arms, psychosocial interventions have been the least studied despite research demonstrating that depression and social isolation are potent risk factors for events in patients with coronary artery disease. The few studies that have examined psychosocial interventions in patients with coronary artery disease have demonstrated a reduction in mortality and recurrent events, suggesting that this treatment strategy may be beneficial. Use of volunteer, patient-driven support groups may provide a cost-effective way to improve social support and enhance altruism in patients with coronary artery disease. Although the psychophysiology of altruism is not well defined, it is possible that altruistic activities might have positive health benefits in patients with coronary artery disease. Studies are needed to explore the roles of low-cost, patient-driven support programs in improving psychosocial functioning and outcomes in patients with coronary artery disease.