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This study of lifestyle change was published in the premier medical...
Dr. Dean Ornish is an American physician and researcher, the presid...
Coronary atherosclerosis affects arteries that carry blood to the h...
Quantitative coronary angiography is a a medical imaging technique ...
82% is a stunning result-> the percentage of patients whose arterie...
The lifestyle change that the patients underwent was only possible ...
This is a major diet change for these individuals, and they were la...
These support groups are essential to sustain behavior change (most...
This study is remarkable: only two other randomized control trials ...
336
Lancet
1990;
129
MEDICAL
SCIENCE
Can
lifestyle
changes
reverse
coronary
heart
disease?
The
Lifestyle
Heart
Trial
In
a
prospective,
randomised,
controlled
trial
to
determine
whether
comprehensive
lifestyle
changes
affect
coronary
atherosclerosis
after
1
year,
28
patients
were
assigned
to
an
experimental
group
(low-fat
vegetarian
diet,
stopping
smoking,
stress
management
training,
and
moderate
exercise)
and
20 to
a
usual-care
control
group. 195
coronary
artery
lesions
were
analysed
by
quantitative
coronary
angiography.
The
average
percentage
diameter
stenosis
regressed
from
40·0
(SD
16·9)%
to
37·8
(16·5)%
in
the
experimental
group
yet
progressed
from
42·7
(15·5)%
to
46·1
(18·5)%
in
the
control
group.
When
only
lesions
greater
than
50%
stenosed
were
analysed,
the
average
percentage
diameter
stenosis
regressed
from
61·1
(8·8)%
to
55·8
(11·0)%
in
the
experimental
group
and
progressed
from
61·7
(9·5)%
to
64·4
(16·3)%
in
the
control
group.
Overall,
82%
of
experimental-group
patients
had
an
average
change
towards
regression.
Comprehensive
lifestyle
changes
may
be
able
to
bring
about
regression
of
even
severe
coronary
atherosclerosis
after
only
1
year,
without
use
of
lipid-lowering
drugs.
Introduction
The
Lifestyle
Heart
Trial
is
the
first
randomised,
controlled
clinical
trial
to
determine
whether
patients
outside
hospital
can
be
motivated
to
make
and
sustain
comprehensive
lifestyle
changes
and,
if
so,
whether
regression
of
coronary
atherosclerosis
can
occur
as
a
result
of
lifestyle
changes
alone.
Over
twenty
clinical
trials
are
being
carried
out
to
determine
whether
the
progression
of
coronary
atherosclerosis
can
be
modified,
in
all
of
these,
cholesterol-
lowering
drugs,
plasmapheresis,
or
partial
ileal
bypass
surgery
are
the
primary
interventions.1
We
carried
out
trials
in
1977
and
1980
to
assess
the
short-term
effects
of
lifestyle
changes
on
coronary
heart
disease
with
non-invasive
endpoint
measures
(improvements
in
cardiac
risk
factors,
functional
status,
myocardial
perfusion,2
and
left
ventricular
function3).
However,
the
subjects
of
those
studies
were
not
living
in
the
community
during
the
trial,
and
we
did
not
use
angiography
to
assess
changes
in
coronary
atherosclerosis.
Patients
and
methods
Patients
with
angiographically
documented
coronary
artery
disease
were
randomly
assigned
to
an
experimental
group
or
to
a
usual-care
control
group.
Experimental-group
patients
were
prescribed
a
lifestyle
programme
that
included
a
low-fat
vegetarian
diet,
moderate
aerobic
exercise,
stress
management
training,
stopping
smoking,
and
group
support.
Control-group
patients
were
not
asked
to
make
lifestyle
changes,
although
they
were
free
to
do
so.
Progression
or
regression
of
coronary
artery
lesions
was
assessed
in
both
groups
by
quantitative
coronary
angiography
at
baseline
and
after
about
a
year.
ADDRESSES:
Pacific
Presbyterian
Medical
Center,
Preventive
Medicine
Research
Institute,
and
Departments
of
Medicine
and
Psychology,
University
of
California
San
Francisco
School
of
Medicine
(D.
Ornish,
MD,
S
E.
Brown,
MD,
J.
H.
Billings,
PhD);
UCSF
School
of
Dental
Public
Health
and
Hygiene
(L.
W.
Scherwitz,
PhD);
Cardiac
Catheterisation
Laboratories,
Pacific
Presbyterian
Medical
Center
(W.
T.
Armstrong,
MD);
Cardiovascular
Research
Institute,
UCSF
School
of
Medicine
(T.
A
Ports,
MD);
Integral
Health
Services,
Inc,
Richmond,
Virginia
(S.
M.
McLanahan,
MD);
Center
for
Cardiovascular
and
Imaging
Research,
University
of
Texas
Medical
School
(R.
L.
Kirkeeide,
PhD,
Prof
K. L.
Gould,
MD);
and
Department
of
Biomedical
and
Environmental
Heath
Science,
University
of
California
School
of
Public
Health,
Berkeley,
California,
USA
(Prof
R.
J.
Brand,
PhD).
Correspondence
to
Dr
D.
Ornish,
Preventive
Medicine
Research
Institute,
1001
Bridgeway
Box
305,
Sausalito,
California
94965,
USA.