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 versus 23.4 +/- 4.1; p <= 0.0001). CPRT, but not CPA, had significantly lower heart rate, blood pressure, and rate-pressure product values after the program (p <= 0.0001). 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 to 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.
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