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Effects of lifestyle modification on the progression of coronary atherosclerosis, autonomic function, and angina : the role of GNB3 C825T polymorphism

Michalsen, Andreas and Knoblauch, Nicola T. M. and Lehmann, Nils and Grossman, Paul and Kerkhoff, Gert and Wilhelm, Frank H. and Moebus, Susanne and Konstantinides, Stavros and Binder, Lutz and Heusch, Gerd and Siffert, Winfried and Budde, Thomas and Dobos, Gustav J.. (2006) Effects of lifestyle modification on the progression of coronary atherosclerosis, autonomic function, and angina : the role of GNB3 C825T polymorphism. American heart journal, 151 (4). pp. 870-877.

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Abstract

BACKGROUND: Given the multimodal medical and interventional treatment options in coronary artery disease, the additional value of intensified lifestyle modification is unclear. We have therefore examined the effects of lifestyle modification on top of current treatment and also associated with the GNB3 C825T polymorphism, which has established association to sympathetic activation and the precipitation of angina. METHODS: One hundred one patients with established coronary artery disease were randomized to a 1-year lifestyle modification group (lifestyle group [LG]) or an advice group. Risk factors, coronary calcification (electron beam tomography), heart rate variability, baroreflex sensitivity, anginal symptoms, and quality of life (QOL) were assessed on entry and after 1 year. RESULTS: Patients in LG had excellent program adherence, but lifestyle modification had no impact on metabolic risk factors and coronary calcification. Changes in heart rate, heart rate variability, and blood pressure were only slightly favoring LG. Baroreflex sensitivity increased by 2 (0.79-3.13) ms/mm Hg in the LG but decreased by -0.10 (-1.11 to 0.92) in the advice group (P = .013). Lifestyle modification led to improved physical QOL, reductions of anginal attacks (-54% vs 11%, P = .01), and dose reductions in 30% of anti-ischemic medications (P = .004). *825T allele carriers had a more pronounced reduction of heart rate and improvement of angina and QOL. The beneficial effect on reduction of medication was seen in *825T allele carriers only. CONCLUSIONS: In the presence of modern treatments, comprehensive lifestyle modification provides no additional benefits on progression of atherosclerosis but improves autonomic function, angina, and QOL with concomitant reduced need of medication. These responses are more pronounced in GNB3*825T allele carriers.
Faculties and Departments:07 Faculty of Psychology
07 Faculty of Psychology > Departement Psychologie > Ehemalige Einheiten Psychologie > Abteilung Klinische Psychologie und Psychiatrie
07 Faculty of Psychology > Departement Psychologie > Ehemalige Einheiten Psychologie > Psychophysiologie (Wilhelm)
UniBasel Contributors:Wilhelm, Frank H
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:C.V. Mosby
ISSN:0002-8703
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:28 Sep 2017 14:37
Deposited On:22 Mar 2012 13:43

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