Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial.
In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.
Ornish
D
D
Pacific Presbyterian Medical Center, Sausalito, California.
Brown
S E
SE
Scherwitz
L W
LW
Billings
J H
JH
Armstrong
W T
WT
Ports
T A
TA
McLanahan
S M
SM
Kirkeeide
R L
RL
Brand
R J
RJ
Gould
K L
KL
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D014676:Diet, Vegetarian; D004041:Dietary Fats / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D000074606:Smoking Prevention; D012944:Social Support; D013312:Stress, Physiological / Q000517:prevention & control; D013997:Time Factors
D004041:Dietary Fats; D008055:Lipids