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Z Kardiol. 1994 Oct;83(10):742-58.

[Value of smoking cessation, physical training and psychological interventions in secondary prevention of coronary heart disease].

[Article in German]

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Abteilung für Kardiologie, Medizinische Hochschule Hannover.


Smoking, physical inactivity, and psychological traits may have substantial impacts on the development and progression of coronary heart disease. In the secondary prevention of coronary heart disease quitting smoking presents the most effective single means. In numerous studies cardiac and total mortality of ex-smokers was reduced by 40-60% when compared to continuous smokers; this effect remained stable over the years or even increased. Regular physical activity is associated with a variety of coronary and cardioprotective mechanisms. Meta-analyses of controlled studies demonstrated a significant reduction in cardiac and total mortality by rehabilitation measures which included physical training. However, this effect diminished in the following years. Psychological measures can lower cardiac risks via several mechanisms. In two major controlled secondary prevention trials interventions aiming at psychological changes such as modification of "coronary prone" type A behavior or application of "stress" reduction measures resulted in a significant decrease in the number of clinical cardiac events during the treatment phase; however, data on the long-term effects beyond the intervention period are still insufficient. In conclusion, in the secondary prevention of coronary heart disease besides strict abstention from smoking a continuous physical training and eventually psychological care in special heart groups of as many qualified patients as possible seems recommendable.

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