Modifications of coronary risk factors.

Full Abstract

In addition to the revascularization and glycemic management interventions assigned at random, the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) design includes the uniform control of major coronary artery disease risk factors, including dyslipidemia, hypertension, smoking, central obesity, and sedentary lifestyle. Target levels for risk factors were adjusted throughout the trial to comply with changes in recommended clinical practice guidelines. At present, the goals are low-density lipoprotein cholesterol <2.59 mmol/L (<100 mg/dL) with an optional goal of <1.81 mmol/L (<70 mg/dL); plasma triglyceride level <1.70 mmol/L (<150 mg/dL); blood pressure level <130 mm Hg systolic and <80 mm Hg diastolic; and smoking cessation treatment for all active smokers. Algorithms were developed for the pharmacologic management of dyslipidemia and hypertension. Dietary prescriptions for the management of glycemia, plasma lipid profiles, and blood pressure levels were adapted from existing clinical practice guidelines. Patients with a body mass index >25 were prescribed moderate caloric restriction; after the trial was under way, a lifestyle weight-management program was instituted. All patients were formally prescribed both endurance and resistance/flexibility exercises, individually adapted to their level of disability and fitness. Pedometers were distributed as a biofeedback strategy. Strategies to achieve the goals for risk factors were designed by BARI 2D working groups (lipid, cardiovascular and hypertension, and nonpharmacologic intervention) and the ongoing implementation of the strategies is monitored by lipid, hypertension, and lifestyle intervention management centers.

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Author information

Author/s: Albu, Jeanine (J); Gottlieb, Sheldon H (SH); August, Phyllis (P); Nesto, Richard W (RW); Orchard, Trevor J (TJ); Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial Investigators;

Affiliation: The New York Obesity Research Center, St. Luke's-Roosevelt Hospital Center, University Hospital of Columbia University, College of Physicians and Surgeons, Columbia University, New York, New York 10025, USA. jba1(-atsign-)columbia.edu

Grants: U01 HL061746 (Agency:NHLBI NIH HHS) ; U01 HL061748 (Agency:NHLBI NIH HHS) ; U01 HL063804 (Agency:NHLBI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: The American journal of cardiology (Am J Cardiol), published in United States. (Language: eng)

Reference: 2006-Jun; vol 97 (issue 12A) : pp 41G-52G

Dates: Created 2006/07/03; Completed 2006/08/01; Revised 2007/11/15;

PMID: 16813737, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Algorithms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Coronary Artery Disease - blood; complications; mortality; therapy
Diabetes Mellitus, Type 1 - blood; complications; mortality; therapy
Dyslipidemias
Humans
Hypertension
Motor Activity

Motor Activity
Myocardial Revascularization
Obesity
Patient Compliance
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Research Design
Risk Factors
Smoking

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