An intensive effort to change the lifestyle in people at high risk of heart disease can help them reduce such risk factors as high blood pressure, cholesterol and smoking.

A trial, called the Euroaction study, published inĀ The Lancet, compared the results of added counseling on lifestyle issues such as diet, physical activity and smoking to the usual care. It included more than 3,000 people with coronary heart disease and 2,300 who were at high risk of developing the disease. Half of the group were counseled by a team of nurses, dietitians, physiotherapists and the treating doctors. The counseling was given to families as well as individuals.

Two groups of patients were studied. One group included patients who already had developed coronary heart disease. The second group included those who were asymptomatic but at high risk because of a combination of risk factors that increase the chances of developing heart disease over 10 years.

Fifty five percent of those getting the counseling reduced their intake of saturated fat vs. 40 percent of those not getting the advice. Increased consumption of fruits and vegetables was seen in 72 percent of the counseled group, and 17 percent of them also increased their consumption of heart-friendly oily fish, compared to 35 percent and 8 percent in the other group. Similar results were seen for blood pressure, cholesterol and physical activity, but it proved difficult to have people seen in general practice quit smoking.