Effect of intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis.
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.
Dod
Harvinder S
HS
Section of Cardiology, Department of Medicine, West Virginia University, Morgantown, West Virginia, USA. hdod@hsc.wvu.edu
Bhardwaj
Ravindra
R
Sajja
Venu
V
Weidner
Gerdi
G
Hobbs
Gerald R
GR
Konat
Gregory W
GW
Manivannan
Shanthi
S
Gharib
Wissam
W
Warden
Bradford E
BE
Nanda
Navin C
NC
Beto
Robert J
RJ
Ornish
Dean
D
Jain
Abnash C
AC
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
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III