A randomized controlled trial of two formats of a program (Women Take PRIDE) to enhance management of heart disease by patients was conducted. Older women (N = 575) were randomly assigned to a group or self-directed format or to a control group. Data regarding symptoms, functional health status, and weight were collected at baseline and at 4, 12, and 18 months. The formats produced different outcomes. At 18 months, the self-directed format was better than the control in reducing the number (p [less than or equal] 0.02), frequency (p [less than or equal] 0.03), and bothersomeness (p [less than or equal] 0.02) of cardiac symptoms. The self-directed format was also better than the group format in reducing symptom frequency of all types (p [less than or equal] 0.04). The group format improved ambulation at 12 months (p [less than or equal] 0.04) and weight loss at 18 months (p [less than or equal] 0.03), and group participants were more likely to complete the program (p less than or equal] 0.05). The availability of different learning formats could enhance management of cardiovascular disease by patients. (Contains 1 figure and 3 tables.)