title: Cardiac rehabilitation for the treatment of women with chest pain and normal coronary arteries.
abstract: OBJECTIVE
  To explore cardiac rehabilitation (CR) as a treatment for psychological and physiological morbidity in women with chest pain and normal coronary arteries (cardiac syndrome X).
  
  
  METHODS
  Sixty-four women aged 57.3+/-8.6 years (mean +/- SD) with cardiac syndrome X were randomly assigned to an 8-week phase III CR exercise program or symptom monitoring control. All women completed the Hospital Anxiety and Depression Scale, Health Anxiety Questionnaire, and Short Form-36 before and after intervention and at the 8-week follow-up. CR patients underwent physical assessment before and after CR.
  
  
  RESULTS
  After CR, patients demonstrated improved symptom severity (2.0+/-0.8 vs 1.26+/-1.1, P=0.009), Hospital Anxiety and Depression Scale depression score (8.0+/-3.4 vs 6.4+/-3.1, P=0.04), total Health Anxiety Questionnaire score (12.0+/-5.5 vs 9.5+/-6.0, P=0.008), health worry (4.5+/-3.1 vs 3.52+/-2.4, P=0.025) and interference (2.4+/-1.8 vs 1.6+/-1.8, P=0.004), SF-36 physical functioning (53.1+/-20.4 vs 62.3+/-23.9, P = 0.006), energy (36.3+/-20.7 vs 49.8+/-19.1, P<0.001), pain (49.9+/-20.7 vs 58.1+/-22.9, P=0.028), and general health (48.8+/-17.9 vs 57.6+/-17.0, P=0.01) not found among the control women. Improvements were maintained at follow-up. CR patients showed significant improvements in Shuttle Walk Test performance (326.8+/-111.0 vs 423.6+/-133.2 m, P<0.001), diastolic blood pressure (84.7+/-9.4 vs 79.7+/-7.3 mm Hg, P=0.007), and body mass index (29.1+/-6.0 vs 28.4+/-6.17 kg/m2, P=0.003).
  
  
  CONCLUSIONS
  An 8-week phase III CR program improves exercise tolerance, quality of life, psychological morbidity, symptom severity, and cardiovascular risk factors in women with cardiac syndrome X.
authors.affiliation: Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, UK. e.asbury@imperial.ac.uk
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Asbury
authors.forename: Colin
authors.initials: C
authors.lastname: Slattery
authors.forename: Amanda
authors.initials: A
authors.lastname: Grant
authors.forename: Lynda
authors.initials: L
authors.lastname: Evans
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Barbir
authors.forename: Peter
authors.initials: P
authors.lastname: Collins
mesh_terms: D000368:Aged; D010054:Brief Psychiatric Rating Scale; D002637:Chest Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006306:Health Surveys; D006801:Humans; D017566:Microvascular Angina / Q000150:complications / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome