Ornish program racks up big heart risk reductions: various socioeconomic populations studied

OB/GYN News, Jan 1, 2004 by Bruce Jancin

ORLANDO, FLA. -- The Ornish program of cardiovascular risk reduction through aggressive lifestyle modification has now been shown to translate well from anything-goes California to the hills of West Virginia and cornfields of Nebraska.

Twelve-week outcomes in 250 participants in the Dr. Dean Ornish Program for Reversing Heart Disease at 13 Midwestern and Appalachian community hospitals constitute "greater reductions in risk factors than have ever before been reported from a community-based lifestyle change program," Dr. Ornish said at the annual scientific sessions of the American Heart Association.

The Ornish program is being offered at hospitals in Kearney, Neb.; Princeton, Parkersburg, Martinsburg, Wheeling, and Charleston, W.Va.; and Windber, Pa., among other locations, with funding from health insurer Highmark Inc. Dr. Ornish and the insurer focused particularly on West Virginia because the state has the highest rate of cardiovascular disease in the nation.

Based on the encouraging results of this 250-patient experience, Medicare has launched a demonstration project involving 1,800 elderly heart patients who are now going through the program at these 13 sites, added Dr. Ornish, president and founder of the Preventive Medicine Research Institute, Sausalito, Calif.

The Ornish program consists of a plant-based diet with no more than 10% of calories from fat, 180 minutes per week of moderate exercise, an hour daily of meditation or other stress-management practices, and biweekly, professionally supervised support group sessions.

"The premise is that when you address these underlying causes of coronary heart disease, that your body has a remarkable capacity to begin healing itself--and much more quickly than had once been realized," he explained. "In our studies over the past 25 years we have used very high-tech, state-of-the-art measures like quantitative coronary angiography and cardiac PET scans to prove how powerful these simple and ancient low-tech interventions can be."

Because some critics have dismissed the Ornish approach as good only for a relatively small number of highly motivated, affluent people with lots of time on their hands, Dr. Ornish took particular delight in highlighting the demographics of participants in his new 250-patient study. More than one-half worked full time, nearly half earned less than $50,000 per year, half didn't have a college degree, and 46% were women.

After 12 weeks, the 250 patients showed statistically and clinically significant improvements in multiple biomedical and psychosocial cardiovascular risk factors.

These included a mean weight loss of 13 pounds, a decrease in body mass index of 2.0 kg/[m.sup.2], blood pressure reductions of 9.6 mm Hg for systolic and 6.1 mm Hg for diastolic, an 18.2 mg/dL decrease in LDL cholesterol, a 19.6 mg/dL drop in triglycerides, and a 25 mg/dL decline in total cholesterol.

Other significant changes included a mean 19% reduction in fasting blood glucose, a 13% decline in hemoglobin [A.sub.1c], a 36% drop in Center for Epidemiologic Studies depression scores, and a 20% decrease in the Cook-Medley Hostility score, added Dr. Ornish, who is also a cardiologist at the University of California. San Francisco.