Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
Lifestyle interventions reduce cardiovascular risk in patients with coronary artery disease: A randomized clinical trial
Background : Nurse-led interventions have proven beneficial to reduce estimated cardiovascular risk . Aim : The purpose of this study was to evaluate the effect of systematic , nurse-led individual lifestyle counseling sessions on the reduction of 10-year cardiovascular risk scores in patients with coronary artery disease ( CAD ) . Methods : This was a r and omized clinical trial of CAD patients treated at a tertiary referral hospital . The intervention group received nurse-led guidance by means of five face-to-face sessions and telephone contact over the course of one year , starting three months after hospital discharge . Exercise and dietary goals were set for each patient and monitored at each session . The control group received st and ard medical advice . Patients were stratified by Framingham risk score and compared at the end of the follow-up period . Results : The final sample comprised 74 patients , 38 in the intervention group and 36 in the control group . Mean age was 58±9 years ; 74 % of patients were male . A 1.7 point ( −13.6 % ) reduction in risk score was recorded in the intervention group , vs a 1.2 point increase in risk score ( + 11 % ) in the control group ( p=0.011 ) . Significant between-group differences were detected for weight ( intervention , 78±14 kg at baseline vs 77±14 kg at study end ; control , 78±15 kg vs 79±15 kg ; p=0.04 ) , systolic blood pressure ( intervention , 136±22 mm Hg vs 124±15 mm Hg ; control , 126±15 mm Hg vs 129±16 mm Hg ; p=0.005 ) , and diastolic blood pressure ( intervention , 82±10 mm Hg vs 77±09 mm Hg ; control , 79±09 mm Hg vs 80±10 mm Hg ; p=0.02 ) . Conclusion : Structured and systematic nurse-led lifestyle counseling effectively reduced cardiovascular risk score
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .