Behavioral interventions from an office setting in patients with cardiac disease

Twenty-nine Ischemic Heart Diseae (IHD) patients (group I) were followed up for as long as 30 months after entering a program emphasizing major changes in diet, exercise, and body weight (BW). Twenty-five similarly selected patients (Group II) had no behavioral interventions and were followed up for six months. The intervention followed a format of an initial series of evening classes, and then periodic visits to the office for consultation with physician and nutritionist. There were no significant changes in diet, self-reported exercise, serum cholesterol, systolic blood pressure (SBP), or BW in group II, but there was a significant reduction (P < .05) in diastolic blood pressure (DBP). By contrast, in the intervention group there were significant changes in the anticipated directions for virtually all measured dietary variables, self-reported exercise, serum cholesterol levels, BW, SBP and DBP, and treadmill exercise time. This was in association with substantial reductions in antihypertensive and other drug therapy, which did not occur in group II. Further analyses within group I showed an independent prediction of changes in treadmill exercise time by changes in BW and changes in self-reported exercise, and also showed that changes in serum cholesterol level were predicted by changes in BW. We conclude that such a program for patients with IHD is feasible in the doctor's office and has some beneficial effects.