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document
Stress reduction prolongs life in women with coronary disease : the Stockholm Women 's Intervention Trial for Coronary Heart Disease ( SWITCHD ) . BACKGROUND Psychosocial stress may increase risk and worsen prognosis of coronary heart disease in women . Interventions that counteract women 's psychosocial stress have not previously been presented . This study implemented a stress reduction program for women and investigated its ability to improve survival in women coronary patients . METHODS AND RESULTS Two hundred thirty-seven consecutive women patients , aged 75 years or younger , hospitalized for acute myocardial infarction , coronary artery bypass grafting , or percutaneous coronary intervention were randomized to a group-based psychosocial intervention program or usual care . Initiated 4 months after hospitalization , intervention groups of 4 to 8 women met for a total of 20 sessions that were spread over a year . We provided education about risk factors , relaxation training techniques , methods for self-monitoring and cognitive restructuring , with an emphasis on coping with stress exposure from family and work , and self-care and compliance with clinical advice . From randomization until end of follow-up ( mean duration , 7.1 years ) , 25 women ( 20 % ) in the usual care and 8 women ( 7 % ) in the stress reduction died , yielding an almost 3-fold protective effect of the intervention ( odds ratio , 0.33 ; 95 % CI , 0.15 to 0.74 ; P=0.007 ) . Introducing baseline measures of clinical prognostic factors , including use of aspirin , beta-blockers , angiotensin-converting enzyme inhibitors , calcium-channel blockers , and statins into multivariate models confirmed the unadjusted results ( P=0.009 ) . CONCLUSIONS Although mechanisms remain unclear , a group-based psychosocial intervention program for women with coronary heart disease may prolong lives independent of other prognostic factors .
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Intervention_Educational
Stress reduction
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Intervention_Educational
stress reduction program
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Intervention_Educational
group-based psychosocial intervention program or usual care .
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Intervention_Educational
education about risk factors
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Intervention_Educational
relaxation training techniques
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Intervention_Educational
methods for self-monitoring and cognitive restructuring
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Intervention_Educational
coping with stress exposure from family and work
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Intervention_Educational
self-care and compliance with clinical advice
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Intervention_Pharmacological
aspirin
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Intervention_Educational
group-based psychosocial intervention program
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Outcome_Mortality
survival in women coronary patients .
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Outcome_Physical
stress reduction
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Outcome_Physical
use of aspirin
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Outcome_Physical
beta-blockers
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Outcome_Physical
angiotensin-converting enzyme inhibitors
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Outcome_Physical
calcium-channel blockers
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Outcome_Physical
statins
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Participant_Sex
women
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Participant_Condition
coronary disease
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Participant_Condition
coronary heart disease
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Participant_Sex
women
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Participant_Sample-size
Two hundred thirty-seven
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Participant_Age
75 years
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Participant_Condition
acute myocardial infarction
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Participant_Condition
coronary artery bypass grafting
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Participant_Condition
percutaneous coronary intervention
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Participant_Sex
women
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Participant_Condition
coronary heart disease