The impact of psychological support strategies on clinical outcomes and quality of life in patients with chronic heart disease: a randomized controlled trial.

BACKGROUND: As chronic heart disease (CHD) continues to rise globally, attention is shifting beyond medical interventions to the psychological dimensions of care. This study examined whether structured psychological support, integrated within a multidisciplinary framework, could enhance clinical outcomes, promote healthier lifestyles, and improve quality of life among CHD patients. METHODS: In a randomized controlled trial, 200 patients with CHD were allocated to either an intervention group—receiving psychological support, educational sessions, dietary counseling, and personalized physical activity—or a control group receiving standard care. The primary outcomes were changes in lipid profiles and cardiac imaging after 12 months. Secondary measures included cardiac events, health-related quality of life (HRQoL), medication adherence, and lifestyle behaviors assessed at 6 and 12 months. Analyses followed the intention-to-treat principle. RESULTS: The intervention group demonstrated better lipid outcomes at 12 months significantly, including lower LDL cholesterol (90 ± 25 vs. 100 ± 30 mg/dL) and higher HDL cholesterol (50 ± 12 vs. 45 ± 10 mg/dL). Cardiac imaging also improved, with higher left ventricular ejection fraction (56.2 ± 6.1% vs. 54.1 ± 6.3%) and lower left atrial volume index (28 ± 7 vs. 32 ± 8 mL/m²). Quality-of-life scores were higher across all SF-36 domains (e.g., mental health: 78 ± 10 vs. 64 ± 15), and psychological outcomes were more favorable, with lower depression (5.4 ± 2.1 vs. 7.8 ± 2.5) and anxiety scores (4.9 ± 1.9 vs. 7.2 ± 2.3). Medication adherence was also higher (91 ± 6 vs. 75 ± 13), and functional capacity improved (390 ± 45 vs. 350 ± 60 m on the 6-minute walk test). CONCLUSION: Embedding psychological support within cardiology care delivers potential benefits in lipid regulation, cardiac performance, and quality of life for CHD patients. These findings highlight the critical role of integrated, patient-centred approaches in optimizing long-term outcomes in cardiac care.