Document Detail

Influence on lifestyle measures and five-year coronary risk by a comprehensive lifestyle intervention programme in patients with coronary heart disease.
MedLine Citation:
PMID:  14671465     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Lifestyle measures of coronary heart disease (CHD) prevention have been overshadowed by the efficacy of drug treatments. This is particularly the case in the setting of secondary prevention where the benefits of lipid lowering, anti-platelet and anti-hypertensive drugs have been emphasised in numerous trials. Lifestyle measures address several CHD risk factors at once and are generally free of serious side effects. OBJECTIVES: The objective of the present study was to determine whether a comprehensive programme of lifestyle modification could favourably influence dietary and exercise habits in addition to smoking cessation over two years. In addition, an attempt was made to evaluate if this programme could favourably influence the five-year CHD-risk in the male population included in the study. DESIGN: A total of 197 patients with proven coronary heart disease were included and randomised to a lifestyle intervention programme or to usual care. Follow-up was after a period of two years. METHODS: Intervention comprised a low fat diet, regular exercise, smoking cessation, psychosocial support and education, delivered by nurses on the rationale for pharmacological and lifestyle measures. Usual care comprised follow-up in the routine outpatient clinic. Both groups were given the same comprehensive medication according to recent guidelines. RESULTS: Patients in the lifestyle intervention group reduced the intake of saturated fat, sugar and cholesterol (P<0.001), increased their exercise level (P<0.01) and stopped smoking (P<0.05) when compared with the usual care group. A sub-analysis of the influence of five-year CHD calculated risk in males resulted in a relative risk reduction of 22% (95% confidence intervals 9-35). Although significant, this result must be interpreted with caution due to poor statistical power and reproducibility of the method. CONCLUSIONS: In the presence of modern drug treatments for secondary cardiovascular disease prevention it remains possible through a favourable diet, exercise and smoking cessation to show an additional reduction in the five-year risk for CHD in males.
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  10     ISSN:  1741-8267     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-12     Completed Date:  2004-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  429-37     Citation Subset:  IM    
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MeSH Terms
Blood Glucose
Blood Pressure / physiology
Cholesterol / blood
Cholesterol, Dietary / administration & dosage
Coronary Disease / prevention & control*
Diet, Fat-Restricted
Dietary Sucrose / administration & dosage
Fatty Acids / administration & dosage
Follow-Up Studies
Health Behavior*
Hospitalization / statistics & numerical data
Life Style*
Middle Aged
Nurse-Patient Relations
Patient Compliance
Risk Factors
Smoking Cessation
Reg. No./Substance:
0/Blood Glucose; 0/Cholesterol, Dietary; 0/Dietary Sucrose; 0/Fatty Acids; 57-88-5/Cholesterol

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