To the Editor: Although the Lifestyle Heart
Trial1 demonstrated that 5 years of aggressive
lifestyle management without the use of lipid-lowering medications resulted
in lesion regression in patients with CAD, clinicians must not lose focus
on current practices and what they can reasonably expect patients to achieve.
Lifestyle management should be used as the first line of treatment in preventing
further events. However, adherence to the strict regimen of Ornish's treatment
group is unlikely to succeed in the majority of patients with CAD, and many
patients with CAD often cannot achieve target plasma lipid values (those associated
with improvement in morbidity and mortality) without the use of medications.
Lear SA. Effect of Lifestyle Changes on Coronary Heart Disease. JAMA. 1999;282(2):130-132. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-2-jbk0714