Arq. Bras. Cardiol. 2024; 121(11): e20240594

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

Cleidiane Andrade, Filipe Ferrari , Ricardo Stein

DOI: 10.36660/abc.20240594i

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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