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

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. 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. 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). 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.