Improvement in medical risk factors and quality of life in women and men with coronary artery disease in the Multicenter Lifestyle Demonstration Project
Section snippets
Recruitment and procedure
Hospital site selection was based on location in geographically diverse areas with sufficient population density (>500,000 people within a 60-minute drive time of the site); a sizeable cardiology program; the demonstration of interest and support from key physicians; and the ability to convince large health insurance providers of the value of including the program in their benefit plan. Accordingly, MLDP teams were trained at 8 sites: Omaha, Nebraska; New York, New York; Des Moines, Iowa; Ft.
Baseline characteristics
Demographic characteristics, medical history, and medications of the 440 patients (79% men) are listed in Table 1. One hundred ninety-four patients (44% of all men and 43% of all women) were approved for a revascularization procedure (Group 1) and 246 (56% of all men and 57% of all women) had a previous revascularization procedure and were in stable condition (Group 2). There was no significant difference in age between men and women. On average, women were socially more disadvantaged than men,
Discussion
The results of this study indicate that this program of comprehensive lifestyle changes can be successfully implemented at hospitals across the country. By the end of 1 year, participants of both the LHT2 and the MLDP reported similar levels of dietary fat intake (LHT, 6.8% of total calories from fat; MLDP, 6.3% for men, 7.6% for women). However, MLDP participants spent fewer hours per week exercising (men 3.7; women 3.0) and practicing stress management (men 4.8; women 4.5) than LHT patients
Acknowledgments
Special appreciation is expressed to Vance Smith, MPH, and Mutual of Omaha. We also like to thank Staffan Avne, MD, for his helpful comments on an earlier version of this manuscript and Megan Campbell, BS, and Jessica Williams, BS, for their invaluable assistance. This study is based, in part, on the primary investigator’s (JK) doctoral thesis submitted to the Karolinska Institute (Stockholm, Sweden) and was completed with the guidance of the corresponding author (GW).
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Dr. Weidner was supported in part by a Research Award from the Alexander von Humboldt Foundation, Bonn, Germany.