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Changing the Lifestyle Changes the Prognosis
After five years, coronary heart disease patients who drastically changed their diets and lifestyles were rewarded with reversed conditions. In comparison, control-group patients got worse. Dean Ornish, M.D., and colleagues recently published findings from the latest and longest study of Ornish's heart-treatment regime in JAMA (1998;280:2001-7).
Twenty patients in the experimental group ate a 10-percent-fat vegetarian diet and participated in moderate aerobic exercise, stress management training, smoking cessation and group psychosocial support. Fifteen control-group patients followed the advice of their personal physicians regarding lifestyle changes consistent with the American Heart Association's Step II diet guidelines. No experimental-group patients took lipid-lowering drugs, while 60 percent of control-group patients did.
Among the findings:
Experimental-group patients reduced their frequency of angina (chest pain) by 91 percent after one year and 72 percent after five years compared with control patients who experienced a 186 percent increase in angina frequency after one year and a 36 percent decrease after five years.
The reduction in low-density lipoprotein levels in the experimental group was comparable with results achieved by lipid-lowering drugs.
Coronary artery blockage in the experimental group decreased by 3.1 percent after five years compared with an 11.8 percent increase in blockage among control patients' arteries.
More than twice as many cardiac events (heart attacks, coronary angioplasty, coronary bypass surgery, cardiac-related hospitalizations or deaths) occurred in the control group compared with the experimental group.
"These findings support the feasibility of intensive lifestyle changes in delaying, stopping or reversing the progression of coronary artery disease in ambulatory patients over prolonged periods," the authors wrote.
—Dena Nishek
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