The Effects of an Intensive Lifestyle Modification Program on Carotid Artery Intima-Media Thickness: A Randomized Trial

Abstract

Purpose. This study evaluated the effect of the Dr. Dean Ornish Program for Reversing Heart Disease on cardiovascular disease as measured by the intima-media thickness of the common carotid artery and compared this effect to outcomes from patients participating in traditional cardiac rehabilitation. Design. Randomized clinical trial. Setting. SwedishAmerican Health System. Subjects. Ninety three patients with clinically confirmed coronary artery disease were randomly assigned to the intervention (n = 46) or traditional cardiac rehabilitation (n = 47). Intervention. Dr. Dean Ornish Program for Reversing Heart Disease. Measures. Ultrasound of the carotid artery and other cardiovascular risk factors were measured at baseline, 6, and 12 months. Analysis. Intent-to-treat analysis. Results. There was no significant reduction in the carotid intima-media thickness of the carotid artery in the Ornish group or the cardiac rehabilitation group. Ornish Program participants had significantly improved dietary habits (p < .001), weight (p < .001), and body mass index (p < .001) as compared with the rehabilitation group. The decrease in the number of patients with angina from baseline to 12 months was 44% in Ornish and 12% in cardiac rehabilitation. Conclusions. The Ornish Program appears to causes improvements in cardiovascular risk factors but does not appear to change the atherosclerotic process as it affects the carotid artery.