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Lifestyle Counseling Reduces Heart Risk
Date:6/13/2008

d consumption of fruits and vegetables was seen in 72 percent of the counseled group, and 17 percent of them also increased their consumption of heart-friendly oily fish, compared to 35 percent and 8 percent in the other group.

Similar results were seen for blood pressure, cholesterol and physical activity, but it proved difficult to have people seen in general practice quit smoking, Wood said.

"But the fact that we ran it in eight countries and both in general hospitals and general practice means that we have demonstrated that this nurse-administered program is practical," he said. "We are looking at cost-effectiveness at this moment, and the early data suggest that it is cost-effective in preventing heart attack and stroke."

"What really was new here was that they actually made an effort to give the advice we know should be given but often isn't," said Dr. Dariush Mozaffarian, an assistant professor of medicine at Harvard Medical School and the Harvard School of Public Health, who wrote an accompanying comment in the journal.

While there have been many trials aimed at improving drug treatment in cardiology, "there are few trials in getting doctors and patients to concentrate on lifestyle," Mozaffarian said. "This shows that a relatively modest intervention can bring dramatic improvements in lifestyle."

However, he added, it's not clear whether such a program could be started in many U.S. hospitals and medical practices. "In principle, every physician should be doing it," he said. "But the system would have to change."

For such a program to work, Mozaffarian said, "policy makers, insurance companies and indicators of quality would have to focus on lifestyle and stimulate hospitals to put preventive measures into place."

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Recommendations on a healthy diet and lifestyle are given by the

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