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 .
Effects of lifestyle modification on coronary artery calcium progression and prognostic factors in coronary patients--3-year results of the randomized SAFE-LIFE trial.
OBJECTIVE Given the multimodal medical and interventional treatment options in coronary artery disease ( CAD ) , the current value of intensified lifestyle modification remains unclear . No r and omized studies have so far assessed the impact of lifestyle modification on coronary artery calcium ( CAC ) . We examined the long-term effects of a one-year comprehensive lifestyle modification on risk factors and CAC by means of a r and omized clinical trial . METHODS 96 participants ( age range 35 - 75 years , 22 women ) of the SAFE-LIFE r and omized trial in patients with established CAD completed 3-year follow-up . The active treatment was a one-year lifestyle modification and stress reduction intervention ( LG ) , while the control group received written advice only ( AG ) .  CAC ( derived from electron beam tomography ) , blood lipids , heart rate , blood pressure , anginal symptoms and quality -of-life were assessed on entry and at 3-year follow-up . RESULTS Lifestyle modification had no impact on change of CAC after three years ( median progression factor [ 25th,75th percentile ] 1.46 [ 1.16,2.19 ] in LG and 1.41 [ 1.20,1.79 ] in AG ; p=0.68 ) , but led to reductions of blood pressure , heart rate and to dose-reductions in anti-ischemic medications as compared to AG . Multiple regression analysis indicated that in the pooled study population increase of CAC was related to psychosocial factors and heart rate . CONCLUSION In the presence of modern treatments , complementary prescription of comprehensive lifestyle modification has no impact on CAC progression but sustainable benefit for blood pressure , heart rate and the need of anti-ischemic medication is demonstrated . A possible influence of stress reduction measures on CAC progression should be further evaluated
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 .