title: Lifestyle interventions reduce cardiovascular risk in patients with coronary artery disease: a randomized clinical trial.
abstract: BACKGROUND
  Nurse-led interventions have proven beneficial to reduce estimated cardiovascular risk.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effect of systematic, nurse-led individual lifestyle counseling sessions on the reduction of 10-year cardiovascular risk scores in patients with coronary artery disease (CAD).
  
  
  METHODS
  This was a randomized clinical trial of CAD patients treated at a tertiary referral hospital. The intervention group received nurse-led guidance by means of five face-to-face sessions and telephone contact over the course of one year, starting three months after hospital discharge. Exercise and dietary goals were set for each patient and monitored at each session. The control group received standard medical advice. Patients were stratified by Framingham risk score and compared at the end of the follow-up period.
  
  
  RESULTS
  The final sample comprised 74 patients, 38 in the intervention group and 36 in the control group. Mean age was 58 ± 9 years; 74% of patients were male. A 1.7 point (-13.6%) reduction in risk score was recorded in the intervention group, vs a 1.2 point increase in risk score (+11%) in the control group (p=0.011). Significant between-group differences were detected for weight (intervention, 78 ± 14 kg at baseline vs 77 ± 14 kg at study end; control, 78 ± 15 kg vs 79 ± 15 kg; p=0.04), systolic blood pressure (intervention, 136 ± 22 mm Hg vs 124 ± 15 mm Hg; control, 126 ± 15 mm Hg vs 129 ± 16 mm Hg; p=0.005), and diastolic blood pressure (intervention, 82 ± 10 mm Hg vs 77 ± 09 mm Hg; control, 79 ± 09 mm Hg vs 80 ± 10 mm Hg; p=0.02).
  
  
  CONCLUSIONS
  Structured and systematic nurse-led lifestyle counseling effectively reduced cardiovascular risk score.
authors.affiliation: Graduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Brazil Cardiovascular Division, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Marco Aurélio Lumertz
authors.initials: MA
authors.lastname: Saffi
authors.affiliation: Graduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Brazil Cardiovascular Division, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Carisi Anne
authors.initials: CA
authors.lastname: Polanczyk
authors.affiliation: Graduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Brazil Nursing School, Federal University of Rio Grande do Sul, Brazil eneidarabelo@gmail.com.
authors.forename: Eneida Rejane
authors.initials: ER
authors.lastname: Rabelo-Silva
mesh_terms: D000368:Aged; D064646:Cardiovascular Nursing / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000451:nursing* / Q000517:prevention & control*; D003376:Counseling / Q000458:organization & administration; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010353:Patient Education as Topic; D012307:Risk Factors; D040242:Risk Reduction Behavior
keywords: Risk factors; coronary artery disease; intervention studies; nursing; patient education; secondary prevention