Program curbs risks in heart patients and partners

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A nurse-led lifestyle intervention program appears to benefit not only people who have had a heart attack but also their partners, researchers said here at the World Congress of Cardiology.

“Having run our prevention program in busy hospitals and general practice settings,” observed Dr. David Wood of, Imperial College London, “these results are directly applicable to every day clinical practice.”

Wood and his colleagues randomly assigned 8,657 heart patients and their domestic partners from eight European countries to receive lifestyle interventions in hospitals or general practice clinics or to receive usual care in either setting.

In hospitals, the prevention program was staffed by nurse educators as well as dietitians and trainers. In general practice clinics, a single nurse-coordinator managed the program.

The intervention emphasized smoking cessation, increased physical activity, as well as a healthy diet that increased the intake of fruits, vegetables and oily fish, while reducing calories from saturated fats. Other program goals included reduction of blood pressure and cholesterol.

Fifty-five percent of the patients in the hospitalized group reduced dietary saturated fat to less than 10 percent of total calories versus 40 percent of the patients in the usual care hospitalized arm.

More than 70 percent of the patients in the hospital intervention group and 72 percent of their partners were able to increase their consumption of fruits to 400 grams a day compared with 35 percent of the patients in the usual care group. Patients in the general practice intervention arm also significantly increased fruit and vegetable consumption, as did their partners.

In smoking cessation, 58 percent of the hospitalized coronary patients in the active intervention stopped smoking after a year compared with 47 percent in usual care. In general practice, 74 percent of those in the intervention group quit versus 72 percent of those in usual care.

Compared to usual care patients, twice as many patients receiving the intervention in hospital or general practice reached exercise goals of 30 to 45 minutes of exercise four to five times week. Likewise, 41 percent of partners of hospitalized patients and 44 percent of partners of general practice intervention patients achieved the exercise goals versus 27 percent and 25 percent in usual care.

Asked about the cost of the program, Wood said that an analysis of the costs and benefits is planned. 

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