Risk factor modification through nonpharmacological interventions in patients with coronary heart disease

Coronary heart disease (CHD) is still the main cause of death in developed countries. Because of improved treatment, many patients survive the acute p hase of a myocardial infarction, which makes secondary prevention of CHD of major importance. Most risk factors responsible for the development and pr ogression of CI-ID are associated with behavior. Therefore, interventions a imed at behavior change may contribute to risk factor modification and seco ndary prevention of CL-ID. The effects of separate risk factor modification efforts by means of randomized, controlled clinical trials of nonpharmacol ogical interventions in patients suffering From CHD are reviewed. Intervent ions aimed at healthy lifestyles may stimulate smoking cessation rates, red uce elevated serum total and low-density lipoprotein (LDL)-cholesterol conc entrations, and favorably modify type A behavior in CHD patients. Moreover, reduction of coronary atherosclerosis has been reported after intensive li festyle and exercise interventions, whereas exercise and type A interventio ns may also lead to reduced Ct-ID morbidity and mortality. As for hypertens ion and obesity, studies aimed at secondary prevention are lacking. (C) 200 0 Elsevier Science Inc. All rights reserved.