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cardiac rehabilitation, perceived stress, psychosocial factors, relaxation therapy



  1. Neves, Angela MSc
  2. Alves, Alberto Jorge MSc
  3. Ribeiro, Fernando MSc
  4. Gomes, Joao Lopes PhD
  5. Oliveira, Jose PhD


PURPOSE: To examine the effect of a cardiac rehabilitation program with relaxation therapy (CPRT) in comparison with cardiac rehabilitation alone on psychological stress, hemodynamic variables, cardiac risk factors, and cardiac-related hospital admissions in patients with coronary artery disease.


METHODS: Patients (N = 81) were randomly assigned to either a 12-week cardiac rehabilitation program alone (CPA) or a CPRT. Perceived stress, blood pressure, heart rate, rate-pressure product value, total cholesterol level, body mass index, smoking status, and physical activity were recorded at baseline and following the 12-week intervention. Cardiac-related hospital admissions were analyzed in a 2-year follow-up.


RESULTS: Perceived stress declined in both groups, although this improvement was significantly superior in the CPRT (31.5 +/- 4.9 vs 23.4 +/- 4.1; P <= .0001). CPRT, but not CPA, had significantly lower heart rate, blood pressure, and rate-pressure product values after the program (P <= .0001). Both groups improved smoking status, physical activity, body mass index, and total cholesterol level. During follow-up, the odds of being admitted to the hospital with cardiac-related problems, after adjusting for heart rate, blood pressure, smoking status, physical activity status, and total cholesterol (OR, 0.37; 95% CI, 0.045-2.98), was not significantly different between groups.


CONCLUSIONS: Relaxation therapy was associated with a positive effect on psychological stress and hemodynamic variables beyond that promoted by cardiac rehabilitation alone.