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Effect of Sustaining Lifestyle Modifications (Nonsmoking, Weight Reduction, Physical Activity, and Mediterranean Diet) After Healing of Myocardial Infarction, Percutaneous Intervention, or Coronary Bypass (from the REasons for Geographic and Racial Differences in Stroke Study)

Guidelines recommend lifestyle modification for patients with coronary heart disease (CHD). Few data demonstrate which lifestyle modifications, if sustained, reduce recurrent CHD and mortality risk in cardiac patients after the postacute rehabilitation phase. We determined the association between id... Full description

Journal Title: The American journal of cardiology 2014, Vol.113 (12), p.1933-1940
Main Author: Booth, John N., MS
Other Authors: Levitan, Emily B., DSc , Brown, Todd M., MD, MSPH , Farkouh, Michael E., MD , Safford, Monika M., MD , Muntner, Paul, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/24793668
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4348576
title: Effect of Sustaining Lifestyle Modifications (Nonsmoking, Weight Reduction, Physical Activity, and Mediterranean Diet) After Healing of Myocardial Infarction, Percutaneous Intervention, or Coronary Bypass (from the REasons for Geographic and Racial Differences in Stroke Study)
format: Article
creator:
  • Booth, John N., MS
  • Levitan, Emily B., DSc
  • Brown, Todd M., MD, MSPH
  • Farkouh, Michael E., MD
  • Safford, Monika M., MD
  • Muntner, Paul, PhD
subjects:
  • Abridged Index Medicus
  • Age Factors
  • Aged
  • Analysis
  • Angioplasty, Balloon, Coronary - methods
  • Angioplasty, Balloon, Coronary - mortality
  • Article
  • Cardiac patients
  • Cardiovascular
  • Cardiovascular disease
  • Cholesterol
  • Confidence Intervals
  • Coronary Artery Bypass - methods
  • Coronary Artery Bypass - mortality
  • Cross-Sectional Studies
  • Diet, Mediterranean
  • Drug therapy
  • Exercise
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Heart attack
  • Heart attacks
  • Humans
  • Life Style
  • lifestyle
  • Male
  • Middle Aged
  • Mortality
  • Motor Activity - physiology
  • Multivariate Analysis
  • Myocardial Infarction - diagnosis
  • Myocardial Infarction - mortality
  • Myocardial Infarction - therapy
  • Obesity
  • Older people
  • Physical fitness
  • Proportional Hazards Models
  • recurrent coronary heart disease
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Smoking - epidemiology
  • Stroke (Disease)
  • Survival Analysis
  • Weight loss
ispartof: The American journal of cardiology, 2014, Vol.113 (12), p.1933-1940
description: Guidelines recommend lifestyle modification for patients with coronary heart disease (CHD). Few data demonstrate which lifestyle modifications, if sustained, reduce recurrent CHD and mortality risk in cardiac patients after the postacute rehabilitation phase. We determined the association between ideal lifestyle factors and recurrent CHD and all-cause mortality in REasons for Geographic and Racial Differences in Stroke study participants with CHD (n = 4,174). Ideal lifestyle factors (physical activity ≥4 times/week, nonsmoking, highest quartile of Mediterranean diet score, and waist circumference
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleEffect of Sustaining Lifestyle Modifications (Nonsmoking, Weight Reduction, Physical Activity, and Mediterranean Diet) After Healing of Myocardial Infarction, Percutaneous Intervention, or Coronary Bypass (from the REasons for Geographic and Racial Differences in Stroke Study)
creatorBooth, John N., MS ; Levitan, Emily B., DSc ; Brown, Todd M., MD, MSPH ; Farkouh, Michael E., MD ; Safford, Monika M., MD ; Muntner, Paul, PhD
creatorcontribBooth, John N., MS ; Levitan, Emily B., DSc ; Brown, Todd M., MD, MSPH ; Farkouh, Michael E., MD ; Safford, Monika M., MD ; Muntner, Paul, PhD
descriptionGuidelines recommend lifestyle modification for patients with coronary heart disease (CHD). Few data demonstrate which lifestyle modifications, if sustained, reduce recurrent CHD and mortality risk in cardiac patients after the postacute rehabilitation phase. We determined the association between ideal lifestyle factors and recurrent CHD and all-cause mortality in REasons for Geographic and Racial Differences in Stroke study participants with CHD (n = 4,174). Ideal lifestyle factors (physical activity ≥4 times/week, nonsmoking, highest quartile of Mediterranean diet score, and waist circumference <88 cm for women and <102 cm for men) were assessed through questionnaires and an in-home study visit. There were 447 recurrent CHD events and 745 deaths over a median 4.3 and 4.5 years, respectively. After multivariable adjustment, physical activity ≥4 versus no times/week and non-smoking versus current smoking were associated with reduced hazard ratios (HRs; 95% confidence interval [CI]) for recurrent CHD (HR 0.69, 95% CI 0.54 to 0.89 and HR 0.50, 95% CI 0.39 to 0.64, respectively) and death (HR 0.71, 95% CI 0.59 to 0.86 and HR 0.53, 95% CI 0.44 to 0.65, respectively). The multivariable-adjusted HRs (and 95% CIs) for recurrent CHD and death comparing the highest versus lowest quartile of Mediterranean diet adherence were 0.77 (95% CI 0.55 to 1.06) and 0.84 (95% CI 0.67 to 1.07), respectively. Neither outcome was associated with waist circumference. Comparing participants with 1, 2, and 3 versus 0 ideal lifestyle factors (non-smoking, physical activity ≥4 times/week, and highest quartile of Mediterranean diet score), the HRs (and 95% CIs) were 0.60 (95% CI 0.44 to 0.81), 0.49 (95% CI 0.36 to 0.67), and 0.38 (95% CI 0.21 to 0.67), respectively, for recurrent CHD and 0.65 (95% CI 0.51 to 0.83), 0.57 (95% CI 0.43 to 0.74), and 0.41 (95% CI 0.26 to 0.64), respectively, for death. In conclusion, maintaining smoking cessation, physical activity, and Mediterranean diet adherence is important for secondary CHD prevention.
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1EISSN: 1879-1913
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languageeng
publisherUnited States: Elsevier Inc
subjectAbridged Index Medicus ; Age Factors ; Aged ; Analysis ; Angioplasty, Balloon, Coronary - methods ; Angioplasty, Balloon, Coronary - mortality ; Article ; Cardiac patients ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Confidence Intervals ; Coronary Artery Bypass - methods ; Coronary Artery Bypass - mortality ; Cross-Sectional Studies ; Diet, Mediterranean ; Drug therapy ; Exercise ; Female ; Follow-Up Studies ; Health Behavior ; Heart attack ; Heart attacks ; Humans ; Life Style ; lifestyle ; Male ; Middle Aged ; Mortality ; Motor Activity - physiology ; Multivariate Analysis ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Obesity ; Older people ; Physical fitness ; Proportional Hazards Models ; recurrent coronary heart disease ; Risk Assessment ; Severity of Illness Index ; Sex Factors ; Smoking - epidemiology ; Stroke (Disease) ; Survival Analysis ; Weight loss
ispartofThe American journal of cardiology, 2014, Vol.113 (12), p.1933-1940
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0Effect of Sustaining Lifestyle Modifications (Nonsmoking, Weight Reduction, Physical Activity, and Mediterranean Diet) After Healing of Myocardial Infarction, Percutaneous Intervention, or Coronary Bypass (from the REasons for Geographic and Racial Differences in Stroke Study)
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descriptionGuidelines recommend lifestyle modification for patients with coronary heart disease (CHD). Few data demonstrate which lifestyle modifications, if sustained, reduce recurrent CHD and mortality risk in cardiac patients after the postacute rehabilitation phase. We determined the association between ideal lifestyle factors and recurrent CHD and all-cause mortality in REasons for Geographic and Racial Differences in Stroke study participants with CHD (n = 4,174). Ideal lifestyle factors (physical activity ≥4 times/week, nonsmoking, highest quartile of Mediterranean diet score, and waist circumference <88 cm for women and <102 cm for men) were assessed through questionnaires and an in-home study visit. There were 447 recurrent CHD events and 745 deaths over a median 4.3 and 4.5 years, respectively. After multivariable adjustment, physical activity ≥4 versus no times/week and non-smoking versus current smoking were associated with reduced hazard ratios (HRs; 95% confidence interval [CI]) for recurrent CHD (HR 0.69, 95% CI 0.54 to 0.89 and HR 0.50, 95% CI 0.39 to 0.64, respectively) and death (HR 0.71, 95% CI 0.59 to 0.86 and HR 0.53, 95% CI 0.44 to 0.65, respectively). The multivariable-adjusted HRs (and 95% CIs) for recurrent CHD and death comparing the highest versus lowest quartile of Mediterranean diet adherence were 0.77 (95% CI 0.55 to 1.06) and 0.84 (95% CI 0.67 to 1.07), respectively. Neither outcome was associated with waist circumference. Comparing participants with 1, 2, and 3 versus 0 ideal lifestyle factors (non-smoking, physical activity ≥4 times/week, and highest quartile of Mediterranean diet score), the HRs (and 95% CIs) were 0.60 (95% CI 0.44 to 0.81), 0.49 (95% CI 0.36 to 0.67), and 0.38 (95% CI 0.21 to 0.67), respectively, for recurrent CHD and 0.65 (95% CI 0.51 to 0.83), 0.57 (95% CI 0.43 to 0.74), and 0.41 (95% CI 0.26 to 0.64), respectively, for death. In conclusion, maintaining smoking cessation, physical activity, and Mediterranean diet adherence is important for secondary CHD prevention.
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39Risk Assessment
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titleEffect of Sustaining Lifestyle Modifications (Nonsmoking, Weight Reduction, Physical Activity, and Mediterranean Diet) After Healing of Myocardial Infarction, Percutaneous Intervention, or Coronary Bypass (from the REasons for Geographic and Racial Differences in Stroke Study)
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8Cardiovascular
9Cardiovascular disease
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42Smoking - epidemiology
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44Survival Analysis
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abstractGuidelines recommend lifestyle modification for patients with coronary heart disease (CHD). Few data demonstrate which lifestyle modifications, if sustained, reduce recurrent CHD and mortality risk in cardiac patients after the postacute rehabilitation phase. We determined the association between ideal lifestyle factors and recurrent CHD and all-cause mortality in REasons for Geographic and Racial Differences in Stroke study participants with CHD (n = 4,174). Ideal lifestyle factors (physical activity ≥4 times/week, nonsmoking, highest quartile of Mediterranean diet score, and waist circumference <88 cm for women and <102 cm for men) were assessed through questionnaires and an in-home study visit. There were 447 recurrent CHD events and 745 deaths over a median 4.3 and 4.5 years, respectively. After multivariable adjustment, physical activity ≥4 versus no times/week and non-smoking versus current smoking were associated with reduced hazard ratios (HRs; 95% confidence interval [CI]) for recurrent CHD (HR 0.69, 95% CI 0.54 to 0.89 and HR 0.50, 95% CI 0.39 to 0.64, respectively) and death (HR 0.71, 95% CI 0.59 to 0.86 and HR 0.53, 95% CI 0.44 to 0.65, respectively). The multivariable-adjusted HRs (and 95% CIs) for recurrent CHD and death comparing the highest versus lowest quartile of Mediterranean diet adherence were 0.77 (95% CI 0.55 to 1.06) and 0.84 (95% CI 0.67 to 1.07), respectively. Neither outcome was associated with waist circumference. Comparing participants with 1, 2, and 3 versus 0 ideal lifestyle factors (non-smoking, physical activity ≥4 times/week, and highest quartile of Mediterranean diet score), the HRs (and 95% CIs) were 0.60 (95% CI 0.44 to 0.81), 0.49 (95% CI 0.36 to 0.67), and 0.38 (95% CI 0.21 to 0.67), respectively, for recurrent CHD and 0.65 (95% CI 0.51 to 0.83), 0.57 (95% CI 0.43 to 0.74), and 0.41 (95% CI 0.26 to 0.64), respectively, for death. In conclusion, maintaining smoking cessation, physical activity, and Mediterranean diet adherence is important for secondary CHD prevention.
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