The American Heart Association (AHA) has a well-established set of lifestyle recommendations for patients with coronary artery disease. These include adopting a low-fat, well-balanced diet, exercising regularly, maintaining a lean body weight, and ceasing smoking. As part of this approach, patients should carefully monitor their blood sugar, cholesterol, and blood pressure levels.

Other lifestyle approaches have also demonstrated success. The Dean Ornish program advocates an extreme reduction in dietary fat in conjunction with exercise and relaxation techniques such as meditation. The arteriograms or angiograms of patients following this program have shown improvement after one to five years. Weight Watchers offers a healthful, balanced plan of eating. Volumetrics by Dr. Barbara Rolls encourages patients to look for big volume, low-calorie-density foods. Any dietary approach that helps patients to achieve healthful weight reduction and weight maintenance can be useful.

Physicians and researchers are increasingly interested in the role that stress plays in heart disease. Can training in stress management help patients who have established artery disease? What is the potential health impact of high-stress occupations? We are currently developing techniques for measuring the effect of emotional stress on the heart, as well as investigating ways to help patients deal with stress, whether through lifestyle training, diet and exercise, or medical therapies.