title: Risk factor modification through nonpharmacological interventions in patients with coronary heart disease.
abstract: Coronary heart disease (CHD) is still the main cause of death in developed countries. Because of improved treatment, many patients survive the acute phase of a myocardial infarction, which makes secondary prevention of CHD of major importance. Most risk factors responsible for the development and progression of CHD are associated with behavior. Therefore, interventions aimed at behavior change may contribute to risk factor modification and secondary prevention of CHD. The effects of separate risk factor modification efforts by means of randomized, controlled clinical trials of nonpharmacological interventions in patients suffering from CHD are reviewed. Interventions aimed at healthy lifestyles may stimulate smoking cessation rates, reduce elevated serum total and low-density lipoprotein (LDL)-cholesterol concentrations, and favorably modify type A behavior in CHD patients. Moreover, reduction of coronary atherosclerosis has been reported after intensive lifestyle and exercise interventions, whereas exercise and type A interventions may also lead to reduced CHD morbidity and mortality. As for hypertension and obesity, studies aimed at secondary prevention are lacking.
authors.affiliation: Department of Medical, Clinical, and Experimental Psychology, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands. ellen.sebregts@MP.unimaas.nl
authors.forename: E H
authors.initials: EH
authors.lastname: Sebregts
authors.forename: P R
authors.initials: PR
authors.lastname: Falger
authors.forename: F W
authors.initials: FW
authors.lastname: Bär
mesh_terms: D001521:Behavior Therapy; D003327:Coronary Disease / Q000517:prevention & control* / Q000534:rehabilitation; D015438:Health Behavior; D006801:Humans; D011315:Preventive Medicine; D012307:Risk Factors; D014434:Type A Personality