title: Achievement of heart health characteristics through participation in an intensive lifestyle change program (Coronary Artery Disease Reversal Study).
abstract: OBJECTIVE
  Lifestyle habits and cardiovascular disease (CVD) risk factors are closely linked. Unfortunately, few individuals meet the goals for cardiovascular health that are recommended in public health initiatives. The purpose of this study was to determine the effect of an intensive lifestyle intervention program on the achievement of a group of recognized heart health characteristics as well as on the reduction of individual CVD risk factors.
  
  
  METHODS
  Of 200 military healthcare beneficiaries with coronary artery disease or CVD risk factors (mean age = 61 years) who entered a 1-year, prospective, cohort, multicomponent lifestyle intervention study (lacto-ovo vegetarian diet, exercise, stress management, group support), 186 subjects enrolled and 144 participated for 1 year.
  
  
  RESULTS
  At 3 months and 1 year compared with baseline, the proportion of subjects meeting 5 recognized heart health characteristics improved (P < .001): fiber intake >25 g/d (94% and 72% vs 35%); exercise > or =150 min/wk (79% and 58% vs 31%); low-density lipoprotein cholesterol <100 mg/dL (75% and 63% vs 46%); body mass index <25 kg/m (34% and 38% vs 23%); and blood pressure <140/90 mm Hg (84% and 83% vs 69%). At 1 year, more subjects (72% vs 32% at baseline), especially those with intervention adherence above (94%) versus below (58%) the study population median (P < .0005), achieved 3 or more of these characteristics.
  
  
  CONCLUSIONS
  An intensive lifestyle intervention promotes achievement of important heart health characteristics that, if maintained, may substantially reduce CVD events.
authors.affiliation: Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Marshall
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Walizer
authors.forename: Marina N
authors.initials: MN
authors.lastname: Vernalis
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D014676:Diet, Vegetarian; D005260:Female; D006293:Health Promotion / Q000379:methods; D006331:Heart Diseases / Q000517:prevention & control*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010809:Physical Fitness; D011446:Prospective Studies; D013315:Stress, Psychological / Q000517:prevention & control
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein