Effectiveness of individual lifestyle interventions in reducing cardiovascular disease and risk factors

In order to assess the effectiveness of lifestyle interventions in reducing cardiovascular disease risk factors, morbidity and mortality among working -age adults, we undertook a systematic review of randomized controlled tria ls of various lifestyle interventions (diet, exercise, smoking cessation, a lcohol intake reduction) in adults followed for 1 year or longer. Twenty-on e single-factor and 21 multifactorial interventions were analysed by outcom e. Changes in cardiovascular morbidity and mortality and total mortality we re considered as main out-comes. Changes in weight, total cholesterol, bloo d pressure, sodium excretion, smoking and alcohol consumption were also ana lysed, and numbers needed to treat were calculated for smoking, morbidity a nd mortality. In secondary prevention, both single and multifactorial lifes tyle interventions were shown to reduce morbidity and mortality, and multif actorial approaches reduced cholesterol levels. Primary prevention was foun d to reduce risk factors efficiently, especially when the intervention is m ultifactorial. Effect sizes were heterogeneous with wide confidence interva ls. Standardized ways of describing interventions, measuring their effects and reporting outcomes systematically would facilitate effect-size evaluati ons. Interventions should optimally be multifactorial and targeted at high- risk patients with multiple risk factors for cardiovascular disease.