Lifestyle Modifications Decrease Coronary and Carotid Atherosclerosis Interview with
Dr. Sunny Jhamnani MD
Clinical Fellow in Cardiology at Yale School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Jhamnani:  Lifestyle modifications are the crux of atherosclerotic disease management. However adherence to them is not adequate. Additionally, randomized controlled trials (RCTs) looking effects of diet and exercise on atherosclerotic disease progression have not been convincing.

We did a systematic review and a meta-analysis of all RCTs looking at the effects of diet and exercise on coronary and carotid atherosclerotic disease progression. We found that , lifestyle modifications were associated with a decrease in coronary atherosclerotic burden in percent stenosis by -0.34 (95% CI: -0.48 to -0.21) standardized mean difference (SMD), with no significant publication bias and heterogeneity (p:0.21, I2:28.25). Similarly, in the carotids, there was a decrease in the carotid intimal medial thickness in mm by -0.21 (95% CI: -0.36 to -0.05) SMD and by -0.13 (95% CI: -0.25 to -0.02) SMD, before and after accounting for publication bias and heterogeneity (p:0.13, I2:39.91 and p:0.54, I2:0), respectively.

Medical Research: What should clinicians and patients take away from your report?

Dr. Jhamnani: There are several take away points from out report.

  1. Lifestyle modifications are associated with decrease in both coronary and carotid atherosclerotic burden.
  2. This degree of decrease in atherosclerotic burden was greater with greater compliance to lifestyle changes. However even with modest levels of compliance, there still was evidence of decrease in atherosclerosis.
  3. These modifications are also associated with improvement of lipid profile, weight and body mass index.

Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Jhamnani:

  1. The importance of diet and exercise and its compliance should be further stressed.
  2. More studies looking at effects of lifestyle modifications should be undertaken.


Meta-analysis of the Effects of Lifestyle Modifications on Coronary and Carotid Atherosclerotic Burden

Jhamnani, Sunny et al.
American Journal of Cardiology
Published Online: October 31, 2014