Life Style Interventions in the Prevention of Coronary Artery Disease

Sridhar Dwivedi

Abstract


Lifestyle diseases particularly coronary artery disease (CAD) has been noted to be the most important   cause of the morbidity and mortality all over the world.  India is currently passing through this epidemic so much  so that it would be taking a heavy toll of Indian youth and economy to the tune of some 1.6 trillion $ during 2015-2030 . The main causative factors for CAD identified as coronary risk factors are: smoking / tobacco, physical inactivity, faulty diet, hypertension, diabetes, high level of cholesterol and stress. As most of these risk factors are lifestyle related attempt to modify them by appropriate interventions form the cornerstone of prevention of CAD epidemic.  Studies done by Dean Ornish and several others prompted us to plan an interventional case control study in 640 patients of established CAD. These cases were given power point presentation regarding healthy lifestyle on one to one basis and followed up at three and six months. Primary outcomes variable were change in smoking /tobacco habits, physical activity, obesity, dietary habits, control of hypertension, diabetes and lipid profile.  At the end of intervention it was possible to bring down the tobacco consumption, improve physical activity, better control of hypertension ( p< 0.03) , reduction in obesity ( p= 0. 0005) and raising HDL cholesterol ( p 0.05 ) significantly in test group.  Taking cue from above study a five step innovative strategy was developed for effective implementation of healthy life style in coronary patients attending Cardiac Clinic at HAH Centenary Hospital, Jamia Hamdard. This strategy  included sensitizing patients to  locally developed visuals , posters and pamphlets at  registration desk , concurrent counseling by attending doctor  at the end of clinical examination ,  and showing patients  and their  family the features of atherosclerosis during  carotid  ultrasound assessment . These points were again reinforced at follow up visits. Initial results of  current  intervention model  is very encouraging   in the sense that > 60% of  subjects quit smoking and close to  50% started regular walking  and taking appropriate diet following our intensive counseling . It is thus possible to modify the risk prone behavior and making such people shun smoking / tobacco consumption, resume regular physical activity and eat appropriate diet. The above interventional model merits further evaluation and extensive application.

Lifestyle diseases particularly coronary artery disease (CAD) has been noted to be the most important   cause of the morbidity and mortality all over the world.  India is currently passing through this epidemic so much  so that it would be taking a heavy toll of Indian youth and economy to the tune of some 1.6 trillion $ during 2015-2030 . The main causative factors for CAD identified as coronary risk factors are: smoking / tobacco, physical inactivity, faulty diet, hypertension, diabetes, high level of cholesterol and stress. As most of these risk factors are lifestyle related attempt to modify them by appropriate interventions form the cornerstone of prevention of CAD epidemic.  Studies done by Dean Ornish and several others prompted us to plan an interventional case control study in 640 patients of established CAD. These cases were given power point presentation regarding healthy lifestyle on one to one basis and followed up at three and six months. Primary outcomes variable were change in smoking /tobacco habits, physical activity, obesity, dietary habits, control of hypertension, diabetes and lipid profile.  At the end of intervention it was possible to bring down the tobacco consumption, improve physical activity, better control of hypertension ( p< 0.03) , reduction in obesity ( p= 0. 0005) and raising HDL cholesterol ( p 0.05 ) significantly in test group.  Taking cue from above study a five step innovative strategy was developed for effective implementation of healthy life style in coronary patients attending Cardiac Clinic at HAH Centenary Hospital, Jamia Hamdard. This strategy  included sensitizing patients to  locally developed visuals , posters and pamphlets at  registration desk , concurrent counseling by attending doctor  at the end of clinical examination ,  and showing patients  and their  family the features of atherosclerosis during  carotid  ultrasound assessment . These points were again reinforced at follow up visits. Initial results of  current  intervention model  is very encouraging   in the sense that > 60% of  subjects have quit smoking and close to  50% have started regular walking  and taking appropriate diet following our intensive counseling . It is thus possible to modify the risk prone behavior and making such people shun smoking / tobacco consumption, resume regular physical activity and eat appropriate diet. The above interventional model merits further evaluation and extensive application.  


Keywords


Lifestyle;coronary artery disease; tobacco use;physical inactivity; faulty diet; intervention.

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References


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