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 .
Multifactorial intervention to prevent recurrent cardiovascular events in patients 75 years or older: the Drugs and Evidence-Based Medicine in the Elderly (DEBATE) study: a randomized, controlled trial.
OBJECTIVE We aim ed to examine whether better use of preventive methods and treatments of cardiovascular disease would reduce recurrent events in home-dwelling patients 75 years or older . METHODS This was a r and omized , controlled trial ( a practical clinical trial , the DEBATE ) , conducted in 2000 to 2003 in Helsinki , Finl and . We recruited 400 vascular patients with mean age of 80 years from the community , and they were r and omly assigned to the intervention group ( n = 199 ) where both nonpharmacological and pharmacological cardiovascular treatments were optimized by a geriatrician according to current guidelines . The control group ( n = 201 ) received the usual care . Main outcome measures were major cardiovascular disease events and total mortality and changes in risk factors and medications . RESULTS The groups were balanced at baseline . Mean duration of follow-up was 3.4 years . At 3 years , drug treatments had become more evidence -based in the intervention group . Consequently , total and low-density lipoprotein cholesterol levels ( P < .0001 ) and systolic ( P = .005 ) and diastolic ( P = .009 ) blood pressure were significantly improved in the intervention group . However , neither primary end points ( 52 and 53 events in the intervention and control groups , respectively ) nor total mortality ( 36 and 35 deaths ) were significantly different between the two groups . No special adverse effects were encountered . CONCLUSION It was possible and safe to institute evidence -based cardiovascular treatments and improve risk factors in patients 75 years or older in a pragmatic setting . During 3.4 years , however , this was not converted to clinical benefits
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 .