Coronary Heart Disease

Lifestyle modification

NUTRITION

  • Saturated fat: Less than 7% of daily calories (1)
  • Trans fat: Less than 1% of daily calories (1)
  • Fibre: > 10g/day (1)
  • Omega 3 from fish or supplements (1)

PHYSICAL ACTIVITY

  • 30-60 min of moderate aerobic physical activity of moderate intensity, eg. brisk walking, 5-7 days a week (1)

WEIGHT

  • Recommended BMI: 18.5 – 25 (1)
  • Waist circumference: < 102 cm for men, < 89 cm for women (1)

SMOKING CESSATION

  • Avoid smoking and environmental tobacco smoke (workplace, at home, etc.) (1)
  • Smoking cessation may reduce ischemic heart disease mortality with about 33%. 10-15 years after smoking cessation the risk is at the same level as non-smokers (1)

POTENTIAL REVERSAL WITH AN INTENSIVE LIFESTYLE INTERVENTION

  • There is some evidence that an intensive and multidomain lifestyle intervention (10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support) may lead to regression of coronary artery plaques and reduction of cardiac events (2)

References

1) https://bestpractice.bmj.com/topics/en-gb/148/management-approach

2) https://jamanetwork.com/journals/jama/fullarticle/188274


Resources

EXPLANATION TO EVIDENCE PRESENTATION

Figure: Evidence pyramid

Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD font

Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE font

​Evidence based on randomized controlled trials is written in PLAIN font

Evidence based on observational / cohort studies is written in CURSIVE font