Life Style Interventions in the Prevention of Coronary Artery Disease.
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Date
2014-01
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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
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.
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Keywords
Lifestyle, coronary artery disease, tobacco use, physical inactivity, faulty diet, intervention
Citation
Dwivedi Sridhar. Life Style Interventions in the Prevention of Coronary Artery Disease. Annals of the National Academy of Medical Sciences (India). 2014 Jan-June; 50(1&2): 45-56.