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July 14, 1999

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

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.

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