Can lifestyle changes reverse coronary heart disease?

Ornish, D.; Brown, S.E.; Billings, J.H.; Scherwitz, L.W.; Armstrong, W.T.; Ports, T.A.; McLanahan, S.M.; Kirkeeide, R.L.; Gould, K.L.; Brand, R.J.

doi:10.1016/0140-6736(90)91656-u

Cited by 2,110Cardiovascular Health and Risk FactorsLipoproteins and Cardiovascular HealthCardiac Health and Mental Health

Can lifestyle changes reverse coronary heart disease?

Ornish, D., Brown, S.E., Billings, J.H., Scherwitz, L.W., Armstrong, W.T., Ports, T.A., McLanahan, S.M., Kirkeeide, R.L. +2 more·1990·The Lancet

DOI 10.1016/0140-6736(90)91656-u

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Abstract

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.

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“research has shown that behavior change in the form of adopting a healthier lifestyle offers a feasible solution in preventing many of these diseases [123].”
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Very low-fat patterns are characterized predominantly by having ≤10% energy from fat.
“Very low-fat patterns are characterized predominantly by having ≤10% energy from fat. 37,[39][40][41]57,58”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [37]

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Authors: Ornish, D., Brown, S. E., Billings, J. H., Scherwitz, L. W., Armstrong, W. T., Ports, T. A., McLanahan, S. M., Kirkeeide, R. L., Gould, K. L., & Brand, R. J.
Affiliations: University of California, San Francisco (US)
The University of Texas System (US)
University of California, Berkeley (US)
Corresponding author: Ornish, D.
ORCID: Kirkeeide, R.L.
Venue: The Lancet
Publisher: Elsevier BV
Published: 1990-07
Volume: 336
Issue: 8708
Pages: 129-133
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/0140-6736(90)91656-u
OpenAlex: W1848464647
Semantic Scholar: f838af21f34cff8c6d5ec2283a4ffd0918e33af6
Cited by: 2,110
References: 25
Citations by year: 2026: 12 · 2025: 18 · 2024: 32 · 2023: 23 · 2022: 34 · 2021: 35 · 2020: 97 · 2019: 37 · 2018: 42 · 2017: 49 · 2016: 42 · 2015: 43 · 2014: 56 · 2013: 44 · 2012: 43
FWCI: 67.54
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (R01 HL42554)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: coronary artery disease, lifestyle modification, smoking cessation, stress management, physical activity, quantitative coronary angiography, lipid-lowering drugs
MeSH terms: Smoking Prevention, Adult, Aged, Combined Modality Therapy, Coronary Artery Disease, Dietary Fats, Female, Humans, Life Style, Lipids, Male, Middle Aged, Patient Compliance, Prospective Studies, Sex Factors, Social Support, Stress, Physiological, Time Factors, Diet, Vegetarian, Exercise, Randomized Controlled Trials as Topic, Coronary Angiography

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Can lifestyle changes reverse coronary heart disease?

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