Skip to main content
Netherlands Heart Journal logoLink to Netherlands Heart Journal
. 2004 Oct;12(10):443-448, 449.

Multidisciplinary structured lifestyle intervention reduces the estimated risk of cardiovascular morbidity and mortality

RLH Sprangers, F Stam, HEC Smid, CDA Stehouwer, IM Hellemans
PMCID: PMC2497152  PMID: 25696263

Abstract

Background

Current guidelines for prevention and treatment of cardiovascular disease (CVD) emphasise the importance of a healthy lifestyle. However, successful lifestyle intervention is proving to be a challenge for healthcare professionals.

Objectives

Evaluation of the effect of lifestyle intervention on cardiovascular risk factors, on reaching treatment targets and on the estimated risk of cardiovascular morbidity and mortality.

Methods

The effect of a six-month multidisciplinary structured lifestyle intervention programme was assessed in 186 patients with and without a history of CVD.

Results

Multidisciplinary structured lifestyle intervention reduced the estimated ten-year risk of cardiovascular morbidity and mortality. The relative risk reduction was similar in patients with and without a history of CVD, the absolute risk reduction was higher in patients with a history of CVD. In both groups blood pressure and body weight decreased, and the maximal work rate and maximal oxygen uptake increased significantly. Blood levels of total cholesterol and cholesterol/HDL ratio decreased significantly in patients with a history of CVD. In addition, target levels for blood pressure and physical fitness were more frequently reached in both patient groups.

Conclusion

Multidisciplinary structured lifestyle intervention had beneficial effects on cardiovascular risk factors. Relative risk reduction was similar in patients with and without evidence of cardiovascular disease. Follow-up is needed to see how well these effects can be maintained.

Keywords: cardiovascular disease, cardiovascular risk, lifestyle intervention, prevention, risk factor, treatment target

Full text

PDF
443

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson K. M., Wilson P. W., Odell P. M., Kannel W. B. An updated coronary risk profile. A statement for health professionals. Circulation. 1991 Jan;83(1):356–362. doi: 10.1161/01.cir.83.1.356. [DOI] [PubMed] [Google Scholar]
  2. Assmann Gerd, Cullen Paul, Schulte Helmut. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Münster (PROCAM) study. Circulation. 2002 Jan 22;105(3):310–315. doi: 10.1161/hc0302.102575. [DOI] [PubMed] [Google Scholar]
  3. Balady G. J., Ades P. A., Comoss P., Limacher M., Pina I. L., Southard D., Williams M. A., Bazzarre T. Core components of cardiac rehabilitation/secondary prevention programs: A statement for healthcare professionals from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation Writing Group. Circulation. 2000 Aug 29;102(9):1069–1073. doi: 10.1161/01.cir.102.9.1069. [DOI] [PubMed] [Google Scholar]
  4. Berlin J. A., Colditz G. A. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990 Oct;132(4):612–628. doi: 10.1093/oxfordjournals.aje.a115704. [DOI] [PubMed] [Google Scholar]
  5. Birkenhäger W. H., de Leeuw P. W. 'Survival of the fittest': invloed van geregelde lichaamsbeweging op gezondheid en levensverwachting. Ned Tijdschr Geneeskd. 2002 Aug 10;146(32):1479–1483. [PubMed] [Google Scholar]
  6. Blair S. N., Kohl H. W., 3rd, Barlow C. E., Paffenbarger R. S., Jr, Gibbons L. W., Macera C. A. Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA. 1995 Apr 12;273(14):1093–1098. [PubMed] [Google Scholar]
  7. Cockcroft D. W., Gault M. H. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. doi: 10.1159/000180580. [DOI] [PubMed] [Google Scholar]
  8. Drexler Andrew J. Lessons learned from landmark trials of type 2 diabetes mellitus and potential applications to clinical practice. Postgrad Med. 2003 May;Spec No:15–26. [PubMed] [Google Scholar]
  9. Ebrahim S., Smith G. D. Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease. BMJ. 1997 Jun 7;314(7095):1666–1674. doi: 10.1136/bmj.314.7095.1666. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Frijling Bernardd, Hulscher Marlies E. J. L., van Leest Lilian A. T. M., Braspenning Jozé C. C., van den Hoogen Henk, Drenthen Antonius J. M., Grol Richard P. T. M. Multifaceted support to improve preventive cardiovascular care: a nationwide, controlled trial in general practice. Br J Gen Pract. 2003 Dec;53(497):934–941. [PMC free article] [PubMed] [Google Scholar]
  11. Gaede Peter, Vedel Pernille, Larsen Nicolai, Jensen Gunnar V. H., Parving Hans-Henrik, Pedersen Oluf. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003 Jan 30;348(5):383–393. doi: 10.1056/NEJMoa021778. [DOI] [PubMed] [Google Scholar]
  12. Giannuzzi P., Mezzani A., Saner H., Björnstad H., Fioretti P., Mendes M., Cohen-Solal A., Dugmore L., Hambrecht R., Hellemans I. Physical activity for primary and secondary prevention. Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. Eur J Cardiovasc Prev Rehabil. 2003 Oct;10(5):319–327. doi: 10.1097/01.hjr.0000086303.28200.50. [DOI] [PubMed] [Google Scholar]
  13. Gordon Neil F., English Carla D., Contractor Aashish S., Salmon Richard D., Leighton Richard F., Franklin Barry A., Haskell William L. Effectiveness of three models for comprehensive cardiovascular disease risk reduction. Am J Cardiol. 2002 Jun 1;89(11):1263–1268. doi: 10.1016/s0002-9149(02)02323-8. [DOI] [PubMed] [Google Scholar]
  14. Jolliffe J. A., Rees K., Taylor R. S., Thompson D., Oldridge N., Ebrahim S. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2001;(1):CD001800–CD001800. doi: 10.1002/14651858.CD001800. [DOI] [PubMed] [Google Scholar]
  15. Koufaki Pelagia, Nash Patrick F., Mercer Thomas H. Assessing the efficacy of exercise training in patients with chronic disease. Med Sci Sports Exerc. 2002 Aug;34(8):1234–1241. doi: 10.1097/00005768-200208000-00002. [DOI] [PubMed] [Google Scholar]
  16. Manson JoAnn E., Greenland Philip, LaCroix Andrea Z., Stefanick Marcia L., Mouton Charles P., Oberman Albert, Perri Michael G., Sheps David S., Pettinger Mary B., Siscovick David S. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med. 2002 Sep 5;347(10):716–725. doi: 10.1056/NEJMoa021067. [DOI] [PubMed] [Google Scholar]
  17. Myers Jonathan, Prakash Manish, Froelicher Victor, Do Dat, Partington Sara, Atwood J. Edwin. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002 Mar 14;346(11):793–801. doi: 10.1056/NEJMoa011858. [DOI] [PubMed] [Google Scholar]
  18. Neuhouser Marian L., Miller Debra L., Kristal Alan R., Barnett Matt J., Cheskin Lawrence J. Diet and exercise habits of patients with diabetes, dyslipidemia, cardiovascular disease or hypertension. J Am Coll Nutr. 2002 Oct;21(5):394–401. doi: 10.1080/07315724.2002.10719241. [DOI] [PubMed] [Google Scholar]
  19. Pickering Thomas G. Lifestyle modification and blood pressure control: is the glass half full or half empty? JAMA. 2003 Apr 23;289(16):2131–2132. doi: 10.1001/jama.289.16.2131. [DOI] [PubMed] [Google Scholar]
  20. Thomsen T. F., Davidsen M., Ibsen H., Jørgensen T., Jensen G., Borch-Johnsen K. A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials; PRECARD and the Copenhagen Risk Score. J Cardiovasc Risk. 2001 Oct;8(5):291–297. doi: 10.1177/174182670100800508. [DOI] [PubMed] [Google Scholar]
  21. de Lorgeril M., Renaud S., Mamelle N., Salen P., Martin J. L., Monjaud I., Guidollet J., Touboul P., Delaye J. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet. 1994 Jun 11;343(8911):1454–1459. doi: 10.1016/s0140-6736(94)92580-1. [DOI] [PubMed] [Google Scholar]

Articles from Netherlands Heart Journal are provided here courtesy of Springer

RESOURCES