Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .
Results of a multicenter randomized clinical trial of exercise and long-term survival in myocardial infarction patients: the National Exercise and Heart Disease Project (NEHDP).
BACKGROUND This study examined whether a supervised exercise program improved 19-year survival in 30- to 64-year-old male myocardial infa rct ion patients . METHODS AND RESULTS The men ( n=651 ) were participants in the National Exercise and Heart Disease Project , a 3-year multicenter r and omized clinical trial conducted in the United States ( 1976 - 1979 ) . The treatment group ( n=315 ) exercised for 8 weeks in a laboratory . Thereafter , they jogged , cycled , or swam in a gymnasium/pool setting guided by an individualized target heart rate . Participants in the control group ( n=319 ) were to maintain normal routines but not participate in any regular exercise program . Participants were followed up until their death or December 31 , 1995 . Cox proportional hazards analysis revealed the all-cause mortality risk estimates ( 95 % CIs ) in the exercise group compared with controls to be 0.69 ( 0.39 to 1.25 ) after an average follow-up of 3 years , 0.84 ( 0.55 to 1.28 ) after 5 years , 0.95 ( 0.71 to 1.29 ) after 10 years , 1.02 ( 0.79 to 1.32 ) after 15 years , and 1.09 ( 0.87 to 1 . 36 ) after 19 years . Cardiovascular disease ( CVD ) mortality risk estimates ( 95 % CI ) for the same follow-up periods were 0.73 ( 0.37 to 1.43 ) , 0.98 ( 0.60 to 1.61 ) , 1.21 ( 0.79 to 1.60 ) , 1.14 ( 0.84 to 1.54 ) , and 1.16 ( 0.88 to 1.52 ) . However , each 1-MET increase in work capacity from baseline to the end of the original trial result ed in consistent reductions in all-cause and CVD mortality risk at each follow-up period , regardless of initial work-capacity level . CONCLUSIONS These findings indicate exercise-program participation result ed in nonsignificantly reduced mortality risks early in the follow-up period . Benefits diminished as time since participation increased , which suggests that the protective mechanisms associated with the program may be short term . Contamination between groups over time could also explain the diminished effects , because increased work capacity provided survival benefits up to 19 years
Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .