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- Geranium (Pelargonium 'Graveolens',* Geraniaceae)
- Acute Myocardial Infarction
- Anxiety
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Date:
10-15-2018 | HC# 031856-602
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Re: Effects of Geranium Aroma on Anxiety in Heart Attack Patients
Shirzadegan
R, Gholami M, Hasanvand S, Birjandi M, Beiranvand A. Effects of geranium aroma
on anxiety among patients with acute myocardial infarction: A triple-blind
randomized clinical trial. Complement
Ther Clin Pract. November 2017;29:201-206. doi:
10.1016/j.ctcp.2017.10.005.
As
one of the most common forms of coronary artery disease, acute myocardial
infarction (AMI), otherwise known as heart attack, is a leading cause of death
with a life-threatening urgency that demands immediate treatment. AMI leads to
disability, fatigue, depression, and sleep disorders. Nearly half (42%) of AMI
patients experience anxiety. When hospitalized for an AMI, patients often experience
severe anxiety during the first 48 hours. Aromatherapy is used to reduce
stress, pain, depression, and anxiety. Geranium (Pelargonium graveolens, Geraniaceae) aerial part essential oil has
antianxiety effects. According to the authors, there are no studies that
evaluate the effect of geranium aromatherapy on patients with AMI. Moreover,
according to the authors, there is a lack of well-designed, rigorous studies
evaluating the safety and effectiveness of geranium aromatherapy for any
condition. Hence, the purpose of this randomized, triple-blind, placebo-controlled
study was to evaluate the effect of geranium aromatherapy on patients with
anxiety and AMI.
Patients
(n = 80) admitted for AMI at the Shahid Madani and Shahid Rahimi Hospitals of
Khorramabad, Iran from December 2016 to May 2017 participated in the study. Included
patients met the following criteria: aged 18-60 years; had a definitive
diagnosis of AMI based on electrocardiography; no cardiopulmonary resuscitation
(CPR) performed upon emergency room admission; no history of allergic rhinitis,
eczema, or known respiratory disorders such as asthma or chronic obstructive
pulmonary disease; no smell or taste disorders; no uncontrolled disorders; no
mental illnesses; no history of head trauma or seizures; no diseases causing
sleep disruption (i.e., migraine, rheumatoid arthritis, or nocturnal
respiratory disorders); no drug addiction; stable vital signs; no pain during screening;
no allergy to study treatments; not using benzodiazepines, analgesics, or
anti-anxiety drugs within 10 hours prior to the study; no history of complementary
and alternative medicine use within one week before the study; and scores >
20 on the State-Trait Anxiety Inventory (STAI). Patients were excluded if they
had any of the following: cardiac shock, cardiopulmonary arrest or MI during
the study, decreased consciousness during the study, cardiac dysrhythmia,
ventricular fibrillation, cardiogenic shock, dysrhythmia, hemodynamic instability,
or death during the study.
Patients
received either geranium or placebo. The geranium treatment was pure geranium
essential oil diluted with 10% primrose (Oenothera
biennis, Onagraceae) oil to a final concentration of 100%. Geranium
treatment was given on the second and third days of the patient's stay in the cardiac
care unit. Those in the placebo group received 12% sunflower (Helianthus annuus, Asteraceae) seed oil.
The nurse put three drops of the geranium essential oil or the sunflower oil on
absorbing patches placed inside each patient's oxygen mask for 20 minutes two
times per day. Patients were treated with aromatherapy for four days. The
geranium and placebo groups received aromatherapy or placebo at different times
and places. Dyspnea, chest pain, dysrhythmia, and changes in vital signs were
assessed daily. Anxiety was measured with the STAI, which was administered 30
minutes before and 15 minutes after the intervention.
The
mean age of the geranium group was 44 years, and the mean age of the placebo
group was 49 years. The baseline demographics were similar between groups. Both
groups had a significant reduction in anxiety over time (P < 0.001). The
geranium group had a significant reduction in the mean anxiety score after each
session of aromatherapy compared with the placebo group (P < 0.001). There
were no reports of dyspnea, chest pain, dysrhythmia, or changes in vital signs.
The
authors conclude that geranium caused a significantly greater decrease in
anxiety compared with placebo. They state that it is safe, easy-to-use, and
inexpensive, and it should be recommended for use in patients in the cardiac care
unit following an AMI. A limitation of the study is that there could have been another
control group who were exposed to a nice smell with no known therapeutic
benefits on anxiety. It is unknown whether the patients were less anxious after
treatment with geranium because they had a pleasant smell as a distraction or
whether geranium was providing a therapeutic benefit.
The
authors declare no conflicts of interest.
—Heather
S. Oliff, PhD
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