Cited by 266Cardiac Health and Mental HealthCardiac Imaging and DiagnosticsAcute Myocardial Infarction Research

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Stress Reduction Prolongs Life in Women With Coronary Disease: The Stockholm Women’s Intervention Trial for Coronary Heart Disease (SWITCHD)

Orth-Gomér, Kristina, Schneiderman, Neil, Wang, Hui-Xin, Walldin, Christina, Blom, May, Jernberg, Tomas·2009·Circulation: Cardiovascular Quality and Outcomes

DOI 10.1161/circoutcomes.108.812859

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Abstract

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, β-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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Orth-Gomér K. Women and heart disease: new evidence for psychosocial behavioral and biological mediators risk and prognosis. Int J Behav Med. 2002; 8: 251–269.
10.1161/circ.103.7.993 · DOI
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Authors: Orth-Gomér, K., Schneiderman, N., Wang, H.-X., Walldin, C., Blom, M., & Jernberg, T.
Affiliations: From the Department of Public Health Sciences (K.O.-G.), Karolinska Institute, Stockholm, Sweden; Behavioral Medicine Program (N.S.), Department of Psychology, Department of Neurobiology (H.-X.W.), Care Sciences and Society, Aging Research Center, University of Miami, Fla; the Department of Cardiology (C.W., M.B., T.J.), Karolinska University Clinics, Stockholm, Sweden; and the Department of Psychosomatics (K.O.-G.), Campus Benjamin Franklin, Charité Universitätsmedizin, Berlin, Germany.
University of Miami (US)
ORCID: Schneiderman, Neil
Wang, Hui-Xin
Jernberg, Tomas
Venue: Circulation: Cardiovascular Quality and Outcomes
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-01
Volume: 2
Issue: 1
Pages: 25-32
ISSN: 1941-7705 (ISSN-L)
1941-7713
DOI: 10.1161/circoutcomes.108.812859
OpenAlex: W2088381623
Cited by: 266
References: 32
Citations by year: 2026: 6 · 2025: 10 · 2024: 10 · 2023: 14 · 2022: 19 · 2021: 20 · 2020: 11 · 2019: 9 · 2018: 12 · 2017: 20 · 2016: 19 · 2015: 12 · 2014: 20 · 2013: 21 · 2012: 28
FWCI: 13.21
Type: journal article
Language: en
Open access: closed
Locations: Circulation Cardiovascular Quality and Outcomes (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Heart, Lung, and Blood Institute (HL-45785, P01HL036588, HL36588, R01HL045785)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords: psychosocial stress, stress reduction, coronary artery disease, women, survival, group intervention, relaxation training, cognitive restructuring, self-care, coping, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention
MeSH terms: Adaptation, Psychological, Aged, Coronary Artery Disease, Female, Humans, Health Knowledge, Attitudes, Practice, Middle Aged, Patient Compliance, Patient Education as Topic, Psychotherapy, Group, Relaxation Therapy, Risk Factors, Self Care, Stress, Psychological, Sweden, Time Factors, Proportional Hazards Models, Odds Ratio, Women's Health, Treatment Outcome, Risk Assessment, Kaplan-Meier Estimate

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Stress Reduction Prolongs Life in Women With Coronary Disease: The Stockholm Women’s Intervention Trial for Coronary Heart Disease (SWITCHD)

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