A systematic review including 23 RCTs with a total of 3,180 subjects was abstracted in DARE. Patients receiving psychosocial interventions (stress management training) showed greater reduction in psychological distress (effect size -0.34), systolic blood pressure (-0.24), heart rate (-0.38), and cholesterol (-0.54). The mortality during the first two years was greater (OR 1.70, 95% CI 1.09 to 2.64) in patients not receiving psychosocial interventions (a 41% reduction), and the occurrence of cardiac events was also greater (OR 1.84, 95% CI 1.12 to 2.99) in those not receiving interventions (a 46% reduction).