Multifactorial lifestyle interventions aim ed at improving modifiable risk factors in patients with established CHD reduce the risk for fatal cardiovascular events .
Therefore , they may have added value in secondary prevention of CHD
CONTEXT Coronary heart disease ( CHD ) is responsible for about 15 % of all deaths worldwide and is identified as a top priority for decision makers .
Both primary and secondary prevention are considered key strategies in the prevention of CHD .
The aim of this study was to assess the efficacy of nonpharmacologic interventions with multiple lifestyle components in patients with established CHD in comparison to usual care .
Comparison of standard- and extended-length participation in cardiac rehabilitation on body composition, functional capacity, and blood lipids.
Participation in a st and ard-length outpatient cardiac rehabilitation program ( CRP ) for 3 months is known to result in positive changes in body composition , functional capacity , and blood lipids in patients with coronary artery disease . However , there has been little attempt to compare patients who remain active in a formal CRP for an extended length of > 1 year with patients who exit after a st and ard length of 3 months . Consequently , 50 patients underwent a series of tests including a maximal grade d exercise treadmill test , assessment of body composition , and  fasting blood lipid analysis  , at entry to CRP and after a follow-up period that ranged from 1 to 5 years . All patients participated in a st and ard multidisciplinary cardiac rehabilitation program for 3 months . Twenty-five patients discontinued participation after 3 months and received no other contact from the program staff until follow-up , whereas 25 patients remained active in the program until follow-up . After statistically adjusting for baseline differences between the groups , significant differences were observed between the extended- and st and ard-length groups at follow-up for body weight ( 177 vs 183 lbs ) , percent fat ( 22 % vs 24 % ) , METS ( 10.5 vs 8.4 ) , high-density lipoprotein level cholesterol ( 44 vs 39 mg/dl ) , total cholesterol/high-density lipoprotein ratio ( 5.2 vs 6.1 ) , and triglycerides ( 134 vs 204 mg/dl ) , respectively . No significant differences in the adjusted means were observed between the groups at follow-up for total cholesterol ( 209 vs 219 mg/dl ) and low-density lipoprotein cholesterol ( 136 vs 138 mg/dl ) . Data from this study demonstrate the efficacy of extended participation in CRP on body composition , functional capacity , and blood lipids . Greater efforts need to be directed at retaining patients in low-cost , center-based maintenance programs and at extending monitoring of patients exiting st and ard length CRPs
Multifactorial lifestyle interventions aim ed at improving modifiable risk factors in patients with established CHD reduce the risk for fatal cardiovascular events .
Therefore , they may have added value in secondary prevention of CHD
CONTEXT Coronary heart disease ( CHD ) is responsible for about 15 % of all deaths worldwide and is identified as a top priority for decision makers .
Both primary and secondary prevention are considered key strategies in the prevention of CHD .
The aim of this study was to assess the efficacy of nonpharmacologic interventions with multiple lifestyle components in patients with established CHD in comparison to usual care .