The objective of this study was to assess the impact of group-based stress management training on emotional well-being, functional status, social activity and chest pain in cardiac patients, within a randomized controlled trial. Fifty acute myocardial infarction and 50 coronary artery bypass patients were randomized to experimental (27 myocardial infarction and 23 coronary artery bypass) and control (23 myocardial infarction and 27 coronary artery bypass) groups 3 months after infarction or surgery. Experimental patients underwent a 10-week relaxation-based stress management programme, while the controls received normal care. Following assessment at the end of the treatment period, controls were offered the stress management programme. Follow-up data were collected 6 months post-treatment from both groups. Significantly greater improvements in emotional well-being as assessed on the Hospital Anxiety and Depression scale (P < 0.005) and the Psychological General Well-being Index (P < 0.001) were found in the experimental than control groups, and improvements were maintained at 6 month follow-up. Greater improvements were also recorded in experimental than control groups in activities of daily living (P < 0.005), satisfaction with health (P < 0.025), reports from spouses or relatives of patients' emotional state (P < 0.001), and in disruption due to chest pain (P < 0.001). Similar responses to stress management were observed in myocardial infarction and coronary artery bypass patients. When controls underwent treatment, they too showed significant reductions in anxiety and depression, but no changes in social or functional status. We conclude that stress management training may lead to improvements in the quality of life of myocardial infarction and coronary artery bypass patients. Such programmes might usefully be made available even to patients who have participated in formal rehabilitation.

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