title: Effect of intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis.
abstract: Intensive lifestyle changes have been shown to regress atherosclerosis, improve cardiovascular risk profiles, and decrease angina pectoris and cardiac events. We evaluated the influence of the Multisite Cardiac Lifestyle Intervention Program, an ongoing health insurance-covered lifestyle intervention conducted at our site, on endothelial function and inflammatory markers of atherosclerosis in this pilot study. Twenty-seven participants with coronary artery disease (CAD) and/or risk factors for CAD (nonsmokers, 14 men; mean age 56 years) were enrolled in the experimental group and asked to make changes in diet (10% calories from fat, plant based), engage in moderate exercise (3 hours/week), and practice stress management (1 hour/day). Twenty historically (age, gender, CAD, and CAD risk factors) matched participants were enrolled in the control group with usual standard of care. At baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) was performed in the 2 groups. Serum markers of inflammation, endothelial dysfunction, and angiogenesis were performed only in the experimental group. After 12 weeks, FMD had improved in the experimental group from a baseline of 4.23 + or - 0.13 to 4.65 + or - 0.15 mm, whereas in the control group it decreased from 4.62 + or - 0.16 to 4.48 + or - 0.17 mm. Changes were significantly different in favor of the experimental group (p <0.0001). Also, significant decreases occurred in C-reactive protein (from 2.07 + or - 0.57 to 1.6 + or - 0.43 mg/L, p = 0.03) and interleukin-6 (from 2.52 + or - 0.62 to 1.23 + or - 0.3 pg/ml, p = 0.02) after 12 weeks. Significant improvement in FMD, C-reactive protein, and interleukin-6 with intensive lifestyle changes in the experimental group suggests > or = 1 potential mechanism underlying the clinical benefits seen in previous trials.
authors.affiliation: Section of Cardiology, Department of Medicine, West Virginia University, Morgantown, West Virginia, USA. hdod@hsc.wvu.edu
authors.forename: Harvinder S
authors.initials: HS
authors.lastname: Dod
authors.forename: Ravindra
authors.initials: R
authors.lastname: Bhardwaj
authors.forename: Venu
authors.initials: V
authors.lastname: Sajja
authors.forename: Gerdi
authors.initials: G
authors.lastname: Weidner
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Hobbs
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Konat
authors.forename: Shanthi
authors.initials: S
authors.lastname: Manivannan
authors.forename: Wissam
authors.initials: W
authors.lastname: Gharib
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Warden
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Beto
authors.forename: Dean
authors.initials: D
authors.lastname: Ornish
authors.forename: Abnash C
authors.initials: AC
authors.lastname: Jain
mesh_terms: D000787:Angina Pectoris / Q000097:blood / Q000517:prevention & control; D050197:Atherosclerosis / Q000097:blood* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000517:prevention & control*; D004730:Endothelium, Vascular / Q000378:metabolism*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D052250:Nitric Oxide Synthase Type III / Q000097:blood; D010865:Pilot Projects; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013315:Stress, Psychological / Q000517:prevention & control; D013997:Time Factors; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III