Laughter Therapy – ABC CARDIOL

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Beyond Humor: Laughter as a Cardiovascular Stimulus

Ricardo Stein et al. Cleidiane da Silva Andrade Filipe Ferrari

Why Laughter Matters to the Cardiovascular System

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, despite substantial advances in pharmacological and interventional therapies. In this context, non-pharmacological strategies that are low-cost, scalable, and accessible have attracted growing interest. Laughter therapy (LT), traditionally associated with psychological well-being, has emerged as a potential adjunctive physiological stimulus capable of eliciting measurable cardiovascular responses.^–

Observational data suggest that individuals with coronary artery disease laugh less frequently and exhibit higher levels of anger and hostility – psychological traits associated with adverse cardiovascular outcomes. Moreover, lower daily laughter frequency has been linked to increased CVD incidence and mortality.^, While these associations do not establish causality, they raise an important physiological question: can laughter itself act as a meaningful cardiovascular stimulus? The hypothesized physiological pathways through which LT may influence autonomic regulation, hemodynamics, and vascular function are summarized in .

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ABC

Editorial

Healing Hearts with Humor: The Potential of Laughter Therapy in Cardiac Rehabilitation

Cleidiane Andrade et al. Filipe Ferrari Ricardo Stein

Introduction

Laughter therapy, also known as humor therapy, utilizes laughter and enjoyment as tools to enhance physical and emotional well-being. This practice offers numerous benefits, including: (1) lowering cortisol levels, thereby reducing stress – a well-established cardiovascular risk factor; (2) improving blood circulation through the release of vasoactive substances; and (3) boosting mood, which helps to combat depression and anxiety – conditions commonly found in patients with cardiovascular diseases and which are also risk factors for the development of coronary artery disease (CAD).^,

A study conducted in the USA involving 48 diabetic patients who had recently experienced a myocardial infarction divided these participants into two groups. One group received standard cardiac rehabilitation in addition to 30-minute daily humor sessions of their choice (intervention), while the other group received only standard rehabilitation (control). The findings revealed that the humor group experienced fewer arrhythmias, reduced levels of epinephrine and norepinephrine in both urine and plasma, a decreased need for nitroglycerin to manage angina, and fewer recurrent infarctions. Additionally, Miller et al. demonstrated that watching a comedy film significantly increases flow-mediated dilation in healthy individuals, whereas viewing stressful films tends to reduce this dilation. Furthermore, an open-label trial with 17 elderly participants who watched stand-up comedy once a week for 4 weeks reported reductions in heart rate and blood pressure, along with increased plasma serotonin levels. Further evidence suggests that patients with cardiovascular disease are less likely to laugh heartily. Moreover, the prevalence of heart disease among the elderly is 1.2 times higher in those who never laugh compared to those who laugh daily.

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Editorial

Evidence-Based Alternative Therapies that “Touch the Heart”

Anderson Donelli da Silveira et al. Ricardo Stein

Introduction

Subcutaneous implantable defibrillator, bioabsorbable polymer stents, transcatheter aortic valve implant for certain patients with severe aortic stenosis, as well as the use of novel anticoagulants, are tangible examples of therapeutic advances in Cardiology in the end of this second decade of the 21^st century. In parallel, despite their infinitely lower financial support and prominence in scientific journals and Cardiology Congresses, the non-pharmacological interventions defined as “alternative” have also been tested with the purpose of improving important outcomes in these patients. In Cardiology, studies also use Meditation, Tai Chi (TC), Yoga and even Laughter Therapy as forms of treatment. In this context, this clinical updating has two objectives: 1) To provide the reader of the Arquivos Brasileiros de Cardiologia (ABC cardiol) with access to information on the alternative therapies aforementioned; 2) To enable them, if they are interested, to use these therapies in their everyday professional life; 3) To show that Brazilian researchers have been publishing articles involving some of these alternative therapies in journals like the Arquivos Brasileiros de Cardiologia, as well as in international high impact journals.

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Beyond Humor: Laughter as a Cardiovascular Stimulus

Why Laughter Matters to the Cardiovascular System

Healing Hearts with Humor: The Potential of Laughter Therapy in Cardiac Rehabilitation

Introduction

Evidence-Based Alternative Therapies that “Touch the Heart”

Introduction

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)