The Extensive Lifestyle Management Intervention (ELMI) after cardiac rehabilitation: a 4-year randomized controlled trial.
BACKGROUND
Previous reports indicate risk factors and lifestyle behaviors may deteriorate early after completion of a cardiac rehabilitation program (CRP). We hypothesized that a modest risk factor and lifestyle management intervention after a CRP would significantly reduce overall cardiovascular risk using the Framingham risk score compared with usual care after 4 years.


METHODS
Patients with ischemic heart disease (n = 302) were randomized after a CRP to either usual care or intervention (exercise sessions, telephone follow-ups, counseling sessions, and reports to the participants' family physicians). The Framingham risk score, risk factors, and lifestyle behaviors were compared after 4 years.


RESULTS
Data were available for 130 intervention and 119 usual care participants. The intervention resulted in 15.5 hours of direct participant contact. Framingham score, total cholesterol, low-density lipoprotein cholesterol, and systolic blood pressure were significantly improved in the intervention group after adjusting for baseline factors. There were no significant differences with respect to lifestyle factors between the groups.


CONCLUSIONS
A modest risk factor and lifestyle management intervention resulted in a significant reduction to global risk compared with usual care and should be considered after CRP.
Lear
Scott A
SA
School of Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada. slear@providencehealth.bc.ca
Spinelli
John J
JJ
Linden
Wolfgang
W
Brozic
Anka
A
Kiess
Marla
M
Frohlich
Jiri J
JJ
Ignaszewski
Andrew
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003920:Diabetes Mellitus / Q000453:epidemiology; D005081:Exercise Therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000453:epidemiology / Q000534:rehabilitation*; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors