Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2003; 8: 520–1
Comprehensive lifestyle modification has shown beneficial effects on coronary artery disease (CAD), yet its effectiveness has not been tested in this era of intensified pharmacological secondary prevention and recent changes in nutritional recommendations. We conducted a randomised, controlled lifestyle trial with extended cardiovascular assessment including coronary calcification (electron beam tomography) to assess the current value of lifestyle approaches in CAD.
A total of 105 patients with CAD were assigned into two groups: (1) intensive program (IP) group (n = 52; age 59 ± 8.7 years) with 100 hours lifestyle training and Mediterranean diet over 12 months. (2) usual care (UC) group (n = 53; age 59.8 ± 8.6 years) with written information only. Primary outcomes included blood pressure, heart rate variability (HRV), baroreceptor function, heart rate, coronary calcium and cardiac symptoms.
Baseline characteristics were comparable, with a high rate of medication with statins (81%). Adherence to proposed lifestyle was significantly improved in the IP group over UC (P < 0.01). Independently of common risk factors, in the IP group a decrease in heart rate (–1.7 ± 8.1 vs. 2.4 ± 5.8; P < 0.01), systolic blood pressure (–5.2 ± 15.1 vs. 2.8 ± 16.8; < 0.05) and an increase in HRV (< 0.05) and baroreceptor function(< 0.05) was observed. Only in the IP group angina pectoris was reduced (< 0.05). Progression of coronary-calcium score was unchanged.
A 1-year comprehensive lifestyle therapy improves blood pressure, autonomic function and symptoms in CAD patients already intensively treated medically. A 3-year follow-up will show if the lifestyle approach may also reduce coronary calcification.
