The Potential of Lifestyle Changes for Improving the Clinical Outcome of Patients with Coronary Heart Disease: Mechanisms of Benefit and Clinical Results

There is overwhelming evidence that smoking cessation, regular physical activity, and combined dietary changes are beneficial in patients with coronary heart disease. Effect size estimates for these lifestyle goals vary between 20% and 35% of mortality rate reductions. Despite the evidence, achieving healthy lifestyles remains the most difficult problem in secondary prevention. In this paper, I review the effects of lifestyle changes on the clinical outcome of patients with coronary heart disease and the underlying mechanisms of benefit, as well as two recently published, controlled, clinical trials addressing the issue of achieving therapeutic lifestyle changes in coronary heart disease patients.