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Efficacy of multifactorial lifestyle interventions in patients with established cardiovascular diseases and high risk
Anneke Blokstra1, Ineke van Dis, Wm Monique Verschuren
1National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, Bilthoven, The Netherlands. anneke.blokstra@rivm.nl
Insights
Multifactorial lifestyle interventions significantly reduce cardiovascular disease (CVD) risk and mortality. Intensive counseling and sustained lifestyle changes, like improved diet and physical activity, are key to long-term success in high-risk individuals.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Lifestyle modification is crucial for managing cardiovascular diseases (CVD) and high-risk individuals.
- Simultaneous interventions targeting multiple risk factors are gaining prominence.
Purpose of the Study:
- To evaluate the efficacy of multifactorial lifestyle interventions (without drug therapy) in patients with established CVD or at high risk.
- To quantify the impact of these interventions on cardiovascular outcomes and risk factors.
Main Methods:
- A comprehensive literature search was performed using PubMed.
- Included randomized controlled trials (RCTs) and reviews of RCTs published between 1990 and 2007.
Main Results:
- Multifactorial lifestyle interventions reduced CVD incidence and mortality, with lasting effects.
- Favorable impacts were observed on biological risk factors, lifestyle, and diabetes incidence.
- Sustained improvements in diet and physical activity were noted long-term, though effects on weight and blood pressure diminished over time.
Conclusions:
- Comprehensive lifestyle advice and intensive counseling are recommended for patients with established CVD and high-risk individuals.
- These interventions should be integrated into medical treatment plans for optimal cardiovascular health.
Background:
Lifestyle modification is recommended for patients with established cardiovascular diseases (CVD) or at high risk of CVD. In recent years, risk factor interventions in which multiple risk factors are addressed simultaneously are increasingly conducted.
Aim:
To determine, and if possible quantify, the efficacy of multifactorial lifestyle interventions (without drug therapy) in patients with established CVD or in high risk groups.
Methods:
A literature search was conducted using 'Pubmed', to identify articles of randomized controlled trials (RCTs) or reviews of RCTs, published between 1990 and 2007.
Results:
In patients with established CVD, multifactorial lifestyle interventions can reduce the occurrence of cardiovascular diseases and/or mortality, even many years after the end of the intervention. Further, in both patients and high risk groups, multifactorial lifestyle interventions have favorable effects on biological risk factors and lifestyle and are able to reduce the incidence of diabetes. In the long-term, in particular lifestyle changes seem to persist, such as improved dietary habits and increased physical activity, while the favorable effects on biological risk factors, such as body weight and blood pressure, are no longer different from the control group. Regular contact with the participants seems to be part of the "success factor".
Conclusion:
It can be recommended to offer patients with established CVD as well as individuals at high risk of CVD a comprehensive lifestyle advice, as part of their medical treatment, combined with intensive counseling.
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