ATTENUATED PROGRESSION OF CORONARY-ARTERY DISEASE AFTER 6 YEARS OF MULTIFACTORIAL RISK INTERVENTION - ROLE OF PHYSICAL EXERCISE

Background It was the aim of this study to assess the long-term effect s of physical exercise and low-fat diet on the progression of coronary artery disease. At the beginning of the study, 113 male patients with coronary artery disease were randomized to an intervention group (n=5 6) or a control group (n=57); 90 patients (80%) could be reevaluated a fter 6 years. Methods and Results Patients in the intervention group ( n=40) showed a reduction in total serum cholesterol (6.03+/-1.03 versu s 5.67+/-1.01 mmol/L; P<.03) and triglyceride levels (1.94+/-0.8 versu s 1.6+/-0.89 mmol/L; P<.005) and maintained their initial body mass in dex (26+/-2 versus 27+/-2 kg/m(2); P=NS), but results were not statist ically different from the control group (n=50) (total serum cholestero l, 6.05+/-1.02 versus 5.79+/-0.88 mmol/L; triglycerides, 2.25+/-1.28 v ersus 1.85+/-0.96 mmol/L [both P=NS]; body mass index, 26+/-2 versus 2 8+/-3 kg/m(2) [P<.0001]). In the intervention group, there was a signi ficant 28% increase in physical work capacity (166+/-59 versus 212+/-8 9 W; P<.001), whereas values remained essentially unchanged in the con trol group (165+/-51 versus 170+/-60 W; P=NS; between groups, P<.05). In the intervention group, coronary stenoses progressed at a significa ntly slower rate than in the control group (P<.0001). Energy expenditu re during exercise was assessed in a subgroup; patients with regressio n of coronary stenoses spent an average of 1784+/-384 kcal/wk (approxi mate to 4 hours of moderate aerobic exercise per week). Multivariate r egression analysis identified only physical work capacity as independe ntly contributing to angiographic changes. Conclusions After 6 years o f multifactorial risk intervention, there is significant and persisten t improvement in lipoprotein levels and physical work capacity, which results in a significant retardation of disease progression. These ben eficial effects appear to be largely due to chronic physical exercise.