Can lifestyle changes reverse coronary heart disease - PDF document

336Lancet 1990;MEDICAL SCIENCECan disease?Triala prospective, trial determine whether affect year, 28 assigned to experimentalgroup diet, stopping a usual-care control group. 195coronary by 133any even thoughmade greater Although numbers affect whetherwomen atherosclerosis with morechanges men in the control group slight more forperiods, and calories lesscontrol-group severely stenosed lesions theAlthough opposite of the finding is since severelyare important clinically. extent to which the change initial site of the Increasing evidence the of the pathogenesis heart lately evidence of was anecdotal. case-reports femoral’9 one several in the ofwith therebymaking necessary for intervention trials be controlled.Only two other trials cholesterol-lowering drugs the primary interventions.changes of heart of determine what measures the angiographicfindings suggest to this needs to good for regresion to although more changes have research be determine contribution the the mechanisms be interesting to examine effects of coronary lifestyle changes that lifestylemay begin atherosclerosis ingrants from andNational theHealth of (no the Henry Airlines, Foundation, the Nathan Foundation, the Corporation, Commerce and Gould, MedicalGeneral Companies, Andersen and Co.,and took the trial Pamela stress Dale Merrit, LawrenceSarah Celeste Jean-Marc Fullsack, Mark Hall, Dale Yvonne Stuart; angiography Luce, angiographers, Brent, Clark, Gabriel Meyer, Anne Robert Marx, Wack;directors, liaison, Patricia Sparier; Rainbird.Arntzenius atherosclerosis. on Preventive Cardiology, DC,June, 1989.2. Ornish DM, AM, al. Effects vegetarian of coronary heart disease. 1979; 3. Ornish Scherwitz management dietary changes treating disease. 249: 54-59.4. arteriography and positron emissiontomography. 78: 237-45.5. measurement clinical laboratories Laboratory theCholesterol Education Program. 1988; 6. Hamilton density lipoproteins Invest 7. Stuff JE, Garza of methods Nutr 1983; 300-06.Pharmacologic cigarette and Engl J Ornish Reversing heart disease. 1990.Patel bio-hypertension. Lancet C, Terry M, Hunt B, Patel M. relaxation four year follow Br Marzetta BR, HM. bloodin regularly 1974; 289-91.College and14. ischemic Med Scand 224: 205-15.WS, ed, al. BMDP3V Berkeley: University Dramaix diseaseLancet 1983; JR, Clarkson TB, et stress Science 1983; 220:Health Reducing of of progress. of the General. DHHS (CDC) Barndt R, patients. Ann Med 20. Kioschos lesions the and systemiccontrol of hyperlipidemia. 1976; 61:D, and ofof coronary disease. Circulation SA, Johnson RL, colestipol-niacin coronary JAMA Brown Schaefer SM, et regress atherosclerosis clinicalB. II-266.Review of clinical Blankenhom RL, formation. in the 131STRESS MANAGEMENT, level smoking TABLE RISK were led by a clinical strategies maintaining to expression of feelings aboutrelationships at Differences groups’ by angiography) and were by a analyses but given dependent. Meanendpoint analysed for variance.ResultsAt baseline, no experimental groups in characteristics risk factors in the and after group [SD 052] (156 = group, but differ between the groups differtable atherosclerosis these patients for the following of arteriograms assessqualitative assessments;analysis 33 were 100%at Adherence stress the lifestyle experimentalgroup was moderate conventional summarises during theperiod. experimental total24-3% and LDL-cholesterol by occurred even patients had reduced of andIN SYMPTOMSto least 130Patients from Presbyterian Medical Center(PPMC) and ofMedicine criteria: age years, female; residence the otherno myocardial preceding weeks, no history of orthree (defined a or coronaryartery); greater 25%; scheduled coronary artery and and care Weand recruited this so additionalneeded for research of patients who the entry underwent coronary of these met Of were to thegroup 43 to the All and accepted into the study. a of gender, informed and the was therelevant angiographic data 7 patient non-quantitative6 while exercise recommendationsin an gym, could tested hospital 1 whoangiogram to 2 views after not owing technical difficulties.by technique. The calibrated at 6 months thereafter. and the angle, skew, and the to allow measurements to be during about later. measures in the view angles, sequence, dye, thesaved used as reference measures San Medical described elsewhere in 4for measurement were h fast) and after year. cholesterol, HDL-cholesterol, triglyceride wereby LDL was HDL-cholesterol were gel electrophoresis focusing.6To check adherence to the patients completed diet at and after assess by USDA database Inc, were complete the frequency, of management said they of Information questionnaires was by 100% adherence theprogramme, nodid than recommended achievedscore than To possibility of group bias CHARACTERISTICS OF EXPERIMENTALout remained unaware of groupand the provided carried out the tests, analysed of sequence group assignment.a retreat at ahotel to to regular meetings Experimental-group patients to eat a low-fatdiet at diet vegetables, products caloricfor whowere except cup milk or The containedapproximately as fat greater than 1), protein, 70-75% intake 5 or patients. Caffeinewas alcohol was limited no more for a history of was encouraged The nutritionallyadequate vitamin meditation, progressive relaxation, imagery.3,9-12 The of relaxation, and awareness. Patientsthese and 1 h tape assistpatient in baseline,entry.prescribed exercise (typicallyto their test Patientswere target heart rate which baselinetreadmill to of maximum heart based identify exertional levels by rate perceived spend a per exercising within their rates. and were at group discussions provided social help patients 105 experimental,