Outcomes of a multidisciplinary coronary heart disease prevention programme in southern India

Coronary heart disease (CHD) is a major cause for mortality and morbidity in India but the focus on lifestyle interventions is very low. This study aims to evaluate the role of a multidisciplinary CHD prevention programme in southern India.

All patients enrolled between May 2014 and March 2016 with CHD (disease group) or with risk factors but no CHD (risk group) were included. Participants attended one-two sessions per week for 6-12 weeks; each session lasted 90-120 min, including exercise and education, and was adapted to the participants' sociocultural requirements. Resting heart rate, systolic and diastolic blood pressure, body mass index (BMI), waist circumference (WC) and functional capacity (FC) were documented at start and end of programme.

Disease group was older (61±10 vs 51±14  years, p<0.01), had lower BMI and WC (26±4 vs 30±7 kg/m², p<0.01; 39±4 vs 42±5 inches, p<0.01), attended more sessions (12±7 vs 6±3, p<0.0001) and had higher completion rates (82% vs 53%, p=0.02) than the risk group. Programme-completers (n=45, 67%) showed significant improvement in health-related behaviour, angina threshold (in all 8 subjects with stable angina), BMI (p=0.03), WC (p<0.01) and FC (p<0.01). Follow-up for a period of 16±6 months showed continued adherence to the healthy behaviour (n=44, 1 lost to follow-up) and maintenance of anthropometric and FC parameters.

A multidisciplinary approach to preventing CHD is lacking in India. This study shows that a comprehensive lifestyle intervention programme has significant benefits and can be incorporated in the routine management of all patients and at-risk individuals in the region.