Abstract
Aim. This study aimed to determine the effect of health promoting lifestyle training on vitality, psychological well-being and blood pressure of women with cardiovascular disease.
Background. Women with cardiovascular disease have many problems in physical and mental health and one of the effective methods in this field is health promoting lifestyle training method.
Method. This was a quasi-experimental study with pretest-posttest and follow-up design with control group. The study population consisted of women with cardiovascular disease referred to Rajaie Cardiovascular Medical and Research Center in Tehran, Iran, in 2019. The sample consisted of 40 women who were selected by purposeful sampling method and randomly allocated into experimental and control group. The experimental group received eight 75-minute educational session (one session per week) on health promoting lifestyle and the control group placed on the waiting list for training. Data were collected using questionnaires vitality and psychological well-being and sphygmomanometer and were analyzed by Chi-square test, independent t-test, repeated measures and Bonferroni post-hoc test in SPSS Version 19.
Findings. In the pretest stage, there was no statically significant difference between the experimental and control group in terms of vitality, psychological well-being and blood pressure, but in the posttest and follow-up stages, there was found a statically significant difference in terms of all three variables of vitality, psychological well-being and blood pressure, meaning that health promoting lifestyle training method led to increase vitality and psychological well-being and decrease blood pressure of women with cardiovascular disease. This effect continued in follow-up stage.
Conclusion. The method of health promoting lifestyle training led to improve the vitality, psychological well-being and blood pressure of women with cardiovascular disease. It is recommended that health care providers use health promoting lifestyle training method along with other educational and therapeutic modalities to improve the health-related components.

Abstract
Aim. The present article aimed at reviewing the literature regarding factors causing arteriosclerosis.
Background. The origin of arteriosclerosis, which leads to the development of cardiovascular diseases, is quite complicated. The pathogens involved in arteriosclerosis include hemodynamic, thrombotic, carbohydrates, lipid, metabolic changes, and the inherent properties of the arterial wall. These physiological and biochemical properties finally give rise to the clinical symptoms in patients. Furthermore, environmental factors such as smoking, and changing lifestyle can aggravate these symptoms. The progression of arteriosclerosis and the increase in its severity depends on these risk factors as well as their continuation over time.
Method. The present research reviewed the literature published within the last 20 years concerning the factors causing arteriosclerosis. The articles were searched out using databases Science Direct, PubMed, Cochrane, Medline, SID, Scopus, Iran Doc, OVID, CINAHL, and Magiran and the keywords were Atherosclerosis, atherosclerosis, cardiovascular disease and their Persian equivalents.
Findings. The findings indicated that there have been considerable developments in identifying the factors causing Atherosclerosis, factors such as age, sex, hypertension, smoking, increase in the LDL level, decrease in the HDL and cholesterol level, which are effective in the development of atherosclerosis, and the metabolic factors (disorder of glucose metabolism), thrombogenic and homeostatic factors such as fibrinogen and inflammatory factors that can lead to cardiovascular diseases. Despite the various studies carried out in this regard, cardiovascular diseases are still the leading cause of death as reported by the World Health Organization and the methods for controlling and preventing these diseases have not yet been completely developed.
Conclusion. Taking into account the high mortality rate of cardiovascular diseases, besides identifying the risk factors leading to arteriosclerosis, there must be public education at every level in order to increase awareness, cause fundamental changes in people’s lifestyles, and increase patient self-care education.

Abstract
Aim. This study aimed to examine the effect of well-being therapy on hope, distress tolerance and death anxiety in people with cardiovascular disease after getting a coronavirus disease 2019 (COVID-19).
Background. Cardiovascular patients rescued from COVID-19 face go through many psychological health issues regarding hope, distress tolerance and death anxiety. Well-being therapy has been known as one of the methods based on positive psychological approach that may have a positive effect on psychological health of these patients.
Method. This study was a semi-experimental study with pretest-posttest design with control group. The statistical population was cardiovascular patients rescued from COVID-19 living in Ahvaz city, Iran, in year 2020, from which 40 people were recruited by convenience sampling method and randomly allocated two experimental and control group. The experimental group received well-being therapy for 10 sessions of 90 minutes duration (two sessions per week) and the control group was placed on the waiting list for training. Research tools were the hope scale, distress tolerance questionnaire and death anxiety scale. Data were analyzed in SPSS-19 using Chi-square test, independent t-test and multivariate analysis of covariance.
Findings. The groups did not differ significantly in terms of gender, marital status, age, education and duration of illness. Also, before intervention, there was no statistically significant difference between the groups in terms of mean scores of hope, distress tolerance and death anxiety. After intervention, statistically significant difference was found between experimental and control group in the mean scores of all three dependent variables, meaning that well-being therapy improved hope (F=114.497, P≤0.0001) and distress tolerance (F=165.032, P≤0.0001), and decreased death anxiety (F=101.408, P≤0.0001) in people with cardiovascular disease after getting a COVID-19.
Conclusion. Regarding the effect of well-being therapy on improving hope and distress tolerance and decreasing death anxiety people with cardiovascular disease after getting a COVID-19, it is recommended that therapists and health professionals apply well-being therapy to improve hope and distress tolerance and decrease death anxiety in people with cardiovascular disease after getting a COVID-19.

Abstract
Aim. The purpose of this study was to examine the health promoting behavior model based on spiritual health, social support and mental capital in people with cardiovascular disease.
Background. Cardiovascular disease affects various aspects of life, including physical, emotional, social and functional health, and one of the factors that affect the quality of life of people with cardiovascular disease is the health promoting behaviors.
Method. In this correlational study, path analysis model was used to examine hypotheses. The statistical population of this study consisted of all people with cardiovascular disease referred to medical centers in Qom in year 2020, out of which 200 people were selected by convenience sampling. Research measurement tools included Lutz Psychological Capital Questionnaire (2007), Zimet et al. Multidimensional Perceived Social Support Scale (1998), Palutzian et al. (1983) Spiritual Health Questionnaire and Walker et al. (1987) Health Promoting Behaviors Questionnaire. Data analysis was performed in AMOS.22 and SPSS.22 software using Pearson correlation method and path analysis model with.
Findings. The results showed that spiritual health (β=0.21, P<0.002) and social support (β= 0.17, P<0.013) had an effect on mental capital. Psychological capital also played a mediating role in the relationship between spiritual health and social support with health promoting behavior (RMSEA=0.067, AGFI=0.98).
Conclusion. It could be concluded that spiritual health, social support and psychological capital play an important role in health promoting behavior of people with cardiovascular disease. Therefore, in developing therapeutic programs for these patients, it is better to emphasize and pay attention to familial, psychological, religious, social and health factors.

Abstract
Aim. This review discusses the exercise training that appear to be effective in cardiovascular patients with Covid-19.
Background. Nowadays, cardiovascular diseases are the pivotal leading causes of death in the world. Given the change of the human lifestyle into a sedentary one, the number of people with cardiovascular disease is rising dramatically. Recently, Covid-19 disease has endangered people's health in many countries and put a lot of pressure on their health care system. It also has had a significant impact on the global economy. The main features of this disease are high transmission rates and mortality. Although the prime cause of death from Covid-19 is respiratory failure, some patients experience severe cardiovascular problems such as congestive heart failure. Although drugs and therapeutic interventions have improved considerably, it is still challenges in prevention and rehabilitation for these diseases, especially in people with Covid-19, and the search for new strategies continues. Cardiac rehabilitation is a set of medical procedures and exercise training that aim to improve the mental status, physical function and overall increase the quality of life. One of the most important parts of cardiac rehabilitation is prescribing exercise.
Method. The keywords “Cardiovascular disease”, “Covid-19”, “Rehabilitation”, and “Exercise training” were searched out in databases, Science Direct, PubMed, Cochrane, Medline, CINAHL, SID, Iran Doc, and Magiran. Out of articles, 210 articles that were more relevant to the research topic were selected. After reviewing the studies thoroughly, 12 studies that were in line with the purpose of the study were selected and reviewed.
Findings. Exercise training prescribed for cardiovascular patients has prescribed over the years ranges from prescribing one type of exercise for all to prescribing exercise for each patient individually based on risk factors, age, and functional status. Continuous aerobic exercise, periodic aerobic exercise, and strength training have been used in most studies. Less intensity should be used when prescribing these exercises to cardiovascular patients with Covid-19.
Conclusion. In general, considering the beneficial effects of rehabilitation training in cardiovascular patients, it seems that a rehabilitation program based on appropriate exercise training can be effective in reducing the complications and mortality of cardiovascular patients with Covid-19. But more studies are needed to get more information.

Abstract
Aim. The aim of this study was to evaluate the effect of stress-based mindfulness therapy on psychological well-being and Covid-19 anxiety in people with cardiovascular disease in Karaj, Iran.
Background. During the Covid-19 pandemic, people with cardiovascular disease have had many problems in the field of psychological health including anxiety. One of the effective modalities to manage anxiety is mindfulness therapy that potentially reduces stress and may affects psychological well-being.
Method. This was a quasi-experimental pretest-posttest study with a control group. The statistical population of the study included all women with cardiovascular disease in Karaj, Iran. Thirty people of the target population were selected by convenience sampling and randomly assigned to experimental and control group (15 people in each group). The research instruments included psychological well-being questionnaire (1989) and Corona anxiety questionnaire. Data were analyzed using descriptive and inferential statistics (multivariate and univariate analysis of covariance) in SPSS software version 19.
Findings The results showed the effect of stress-based mindfulness on psychological well-being and Corona anxiety in women with cardiovascular disease (p≤0.0001). The intervention explained 43% of the variance of psychological well-being and 24% of the Corona anxiety.
Conclusion. Considering the effectiveness of stress-based mindfulness therapy on psychological well-being and Corona anxiety in people with cardiovascular disease, it is suggested to apply this treatment method in psychological clinics and health centers to improve mental health.

Abstract
Aim. This study was conducted to compare the effect of positivism education and health promoting lifestyle education on psychological well-being and health anxiety in people with cardiovascular disease.
Background. People with cardiovascular disease have problems in the terms of psychological well-being and health anxiety and positivism education and health promoting lifestyle education are likely to be effective in improving psychological well-being and health anxiety.
Method: The present study was a semi-experimental study with pre-test and post-test design with a control group. The study population consisted of people with cardiovascular disease who referred to Golestan Hospital of Ahvaz city, Iran, in 2021. Sixty people were recruited by purposive sampling method based on inclusion criteria and randomly assigned to three equal groups. Experimental groups separately underwent 8 sessions of 90-minute duration by positivism education and health promoting lifestyle education, respectively, and during this time the control group did not receive any intervention. Data were collected by the demographic information form, short form health anxiety inventory and psychological well-being revisited questionnaire, and were analyzed by Chi-square, univariate analysis of variance, multivariate analysis of covariance and Bonferroni post-hoc test in SPSS-19 software.
Findings. The findings showed that the experimental and control groups did not significantly differ in terms of gender, education level, age and duration of cardiovascular disease. Both methods of positivism education and health promoting lifestyle education were effective in improving psychological well-being and health anxiety in people with cardiovascular disease (P≤0.0001), but there was no statistically significant difference between the intervention methods in improving psychological well-being and health anxiety.
Conclusion. The effect of both methods of positivism education and health promoting lifestyle education on improving psychological well-being and health anxiety was confirmed and there was no significant difference between these methods in improving psychological well-being and health anxiety. Therefore, health professionals and therapists can use both methods to improve health-related characteristics.
 

Abstract
Aim. The purpose of this study is to review studies that have investigated the effect of family-centered self-care program on the activity of people with cardiovascular disease after hospital discharge.
Background. Adherence to medication, diet and physical activity in people with cardiovascular disease is very crucial to prevent readmission, independence in daily activities, and complications.
Method. In this review study, a comprehensive search of scientific databases and search engines such as Science Direct, Scopus, PubMed, Google Scholar, and Medline using the keywords cardiovascular disease, adherence to treatment regimen, and family-centered self-care program in both Persian and English languages was done to find articles published between 2000 and 2020.
Findings. Family-centered post-discharge self-care program can be a principled and effective method to increase adherence to medication, diet and physical activity in heart people with cardiovascular disease.
Conclusion. One of the most important factors in effectiveness of self-care is active family participation and family-centered self-care, which can be effective in three areas after the discharge of people with cardiovascular disease.

Abstract
Aim. This review study was conducted with the aim of highlighting the importance of a preoperative preventive approach in the recovery of patients undergoing coronary artery bypass surgery.
Background. With the increase in the number of patients who are candidated for heart surgery, improving the health status before the operation is of great importance to optimize the results after the operation. This review has been conducted with the aim of evaluating the evidence related to the pre-rehabilitation of patients undergoing coronary artery bypass surgery.
Method. The present literature review was conducted by searching out library resources and databases, Scopus, Chochrane Library, Magiran, SID, PubMed, Up-to-date, OVID, CINAHL, and Web of Science with the keywords, coronary artery bypass surgery, pre-rehabilitation, cardiovascular disease and their Persian equivalents without time limit. From a total of 104 articles, 63 full texts articles entered the review stage, of which 17 articles entered the literature review.
Findings. The findings indicate the favorable effects of pre-rehabilitation on improving the quality of life and preventing complications in the early postoperative period. Pre-rehabilitation programs should adopt multifaceted approaches including nutrition, exercise, and anxiety reduction to improve patient resilience in the preoperative period. The pre-operative period is a critical opportunity to implement pre-rehabilitation interventions for vulnerable patients awaiting cardiac surgery.
Conclusion. Cardiac pre-rehabilitation includes a wide range of preventive interventions that can be taught by nurses to patients undergoing cardiac surgery. Pre-rehabilitation requires an interdisciplinary approach, because it suggests a change from the current model of health care and transformation from one-dimensional care to interdisciplinary care, which can be an effective tool for the medical and nursing system in timely identification of physical and mental disorders in initial preoperative assessment, preoperative education and management, as well as prevention of postoperative complications.

Abstract
Aim. The purpose of this study was to investigate the effect of mindfulness training on Corona anxiety in patients with Covid-19 and underlying cardiovascular disease in Imam Ali Hospital, Amol, Iran.
Background. Since its outbreak, the corona virus has shown that it defeats more people with underlying diseases and puts them at risk of death than those who have a healthy body.
Method. This was a quasi-experimental study with control group. The accecible population of this research was all corona patients with a history of cardiovascular disease in Imam Ali Hospital, Amol, Iran, in 2021-2022. Sampling was done from the patients admitted to the hospital based on convenience sampling method. To collect information, the Corona Virus Anxiety Questionnaire developed by Alipour et al. (2018) was used. Mindfulness training based on Kabat-Zinn (2005) educational plan was implemented in experimental group in 8 sessions of 2-hour duration per week.
Findings. The results of multivariate covariance analysis showed that mindfulness training has an effect on reducing anxiety of Corona in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.87 (p≤0.001). Univariate covariance analysis showed that mindfulness training has an effect on reducing the mental symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.83 (p≤0.001). Also, mindfulness training has an effect on reducing physical symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease by 0.79 (p≤0.001).
Conclusion. Mindfulness exercises can enable patients with Covid-19 and underlying cardiovascular disease to pause and reflect a little before responding, and these pauses provide them with an opportunity. It allows them to get rid of judgment in many situations that can lead to anger, fear and anxiety. This will provide conditions that patients, even in the worst and acute state of their illness, are more likely to be able to maintain their mental peace and thereby, reduce the physical signs and symptoms of anxiety.

Aim. The present study was conducted with the aim of reviewing the role of serum albumin in heart failure.
Background. Heart failure is a complex clinical syndrome that affects a large population worldwide yearly, and its mortality is even higher than that of many cancers. Although the identification of traditional risk factors has helped in primary prevention, the death rate due to this disease is still increasing. Identifying potential and modifiable risk factors that are not known yet seems necessary in this situation. Serum albumin has been known for many years as a strong prognostic biomarker in many pathological conditions. In recent years, studies have been conducted regarding the role of serum albumin in the prediction, prognosis and treatment of heart failure symptoms.
Method. This narrative study was conducted in 2023. For this purpose, the data bases, PubMed, Scopus, Web of Sciences, SID, MagIran were searched out with the keywords albumin, heart failure, diastolic failure, systolic failure, and a total of 30 articles were included in the study.
Findings. Hypoalbuminemia is a common finding in patients with heart failure, and among its main causes in heart failure are malnutrition, inflammation, lack of intestinal function, lack of kidney function, and liver disease. According to clinical and experimental evidence, hypoalbuminemia is related to fluid retention and exacerbation of pulmonary edema in these patients. Also, hypoalbuminemia can independently predict the onset of a new heart failure and can be measured as a prognostic factor of heart failure outcomes. However, there is still no evidence that directly shows the benefit of albumin injection in patients with heart failure.
Conclusion. Serum albumin can be measured as a modifiable risk factor and a prognostic factor in heart failure, but it is necessary to limit its use to cases where its effectiveness has been confirmed.

Abstract
Aim. This study was conducted with the aim of determining the effect of emotion-focused couple therapy on marital life quality, covert relational aggression and psychological health of couples with cardiovascular disease.
Background. Patients with cardiovascular disease face many problems in their marital life and psychological health, and the use of couple therapy methods is necessary to improve them.
Method. This study was a semi-experimental pretest-posttest design with control group. The study population was patients with cardiovascular disease (including hypertension, acute coronary syndrome, infarction, angina pectoris and constrictive pericarditis) referred to Razi Hospital in Ahvaz city, Iran in 2023. The sample size for each group was considered to be 13 couples, and these couples were selected by purposive sampling method based on inclusion criteria. The experimental group received 8 sessions of 90 minutes duration (two sessions per week) in the form of emotion-focused couple therapy and during this time, the control group did not receive any intervention. Data were collected with the scales marital life quality (Zhang et al., 2013), covert relational aggression (Nelsno & Carroll, 2006) and psychological health (Najarian & Davoodi, 2001) and were analyzed with Chi-square test, independent t-test and multivariate analysis of covariance in SPSS-26 software.
Findings. There was no statistically significant difference between the experimental and control groups in terms of age, education, illness duration and type of couple illness. In the pre-test stage, the groups did not differ significantly in terms of the mean score of marital life quality, covert relational aggression and psychological health, but in the post-test stage, there was a statistically significant difference in the mean score of all three variables (P≤0.0001). In this way, the emotion-focused couple therapy improved married life quality (F=125.366, P≤0.0001), reduced covert relational aggression (F=206.601, P≤0.0001) and improved psychological health (F=175.052, P≤0.0001) in couples with cardiovascular disease.
Conclusion. The results of this study showed the effect of emotion-focused couple therapy on improving the marital life quality, reducing the covert relational aggression, and improving the psychological health of couples with cardiovascular disease. Therefore, counselors and therapists can use emotion-focused couple therapy along with other effective treatment methods to improve variables related to marital life and psychological health.