The overall results for modifiable risk factors suggested improvements in dietary and exercise outcomes but no overall effect on smoking outcomes .
The effectiveness of lifestyle interventions within secondary prevention of coronary heart disease ( CHD ) remains unclear .
This systematic review aim ed to determine their effectiveness and included r and omized controlled trials of lifestyle interventions , in primary care or community setting s , with a minimum follow-up of three months , published since 1990 .
A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
BACKGROUND There are approximately 1.8 million patients with angina in the United Kingdom , many of whom report a poor quality of life , including raised levels of anxiety and depression . AIM To evaluate the effect of a cognitive behavioural disease management programme , the Angina Plan , on psychological adjustment in patients newly diagnosed with angina pectoris . DESIGN OF STUDY R and omised controlled trial . SETTING Patients from GP practice s in a Northern UK city ( York ) between April 1999 and May 2000 . METHOD Recruited patients were r and omised to receive the Angina Plan or to a routine , practice nurse-led secondary prevention educational session . RESULTS Twenty of the 25 practice s invited to join the study supplied patients ' names ; 142 patients attended an assessment clinic and were r and omised There were no significant differences in any baseline measures . At the six month post-treatment follow-up , 130 ( 91 % ) patients were reassessed . When compared with the educational session patients ( using analysis of covariance adjusted for baseline scores in an intention-to-treat analysis ) Angina Plan patients showed a greater reduction in anxiety ( P = 0.05 ) and depression ( P = 0.01 ) , the frequency of angina ( reduced by three episodes per week , versus a reduction of 0.4 per week , P = 0.016 ) the use of glyceryl trinitrate  ( reduced by 4.19 fewer doses per week versus a reduction of 0.59 per week , P = 0.018 ) , and physical limitations ( P<0.001 : Seattle Angina Question naire ) . They were also more likely to report having changed their diet ( 41 versus 21 , P<0.001 ) and increased their daily walking ( 30 versus 2 , P<0.001 ) . There was no significant difference between the groups on the other sub-scales of the Seattle Angina Question naire or in any of the medical variables measured . CONCLUSION The Angina Plan appears to improve the psychological , symptomatic , and functional status of patients newly diagnosed with angina
The overall results for modifiable risk factors suggested improvements in dietary and exercise outcomes but no overall effect on smoking outcomes .
The effectiveness of lifestyle interventions within secondary prevention of coronary heart disease ( CHD ) remains unclear .
This systematic review aim ed to determine their effectiveness and included r and omized controlled trials of lifestyle interventions , in primary care or community setting s , with a minimum follow-up of three months , published since 1990 .