Can lifestyle changes reverse coronary heart disease?

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Abstract

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography.

The average percentage diameter stenosis regressed from 40·0 (SD 16·9)% to 37·8 (16·5)% in the experimental group yet progressed from 42·7 (15·5)% to 46·1 (18·5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61·1 (8·8)% to 55·8 (11·0)% in the experimental group and progressed from 61·7 (9·5)% to 64·4 (16·3)% in the control group.

Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.

Source: Omish D, Brown SE, Scherwitz LW, et al. “Can lifestyle changes reverse coronary heart disease?” Lancet 336 (1990): 129-133.