관상동맥죽상경화증 환자에서 식생활요법 후 관상동맥경화증의 변화

Objectives: Coronary atherosclerosis is a life-style disease. Recently, Ornish et al. reported regression of coronary atherosclerosis in subjects with coronary artery disease who participated in a strict life-style modification program. We studied the effects of a life-style modification program on Korean patients with coronary atherosclerosis. Methods: Fourteen patients with angiographically documented coronary artery narrowing of over 50% in at least one vessel were studied prospectively. Subjects were divided into two groups. Subjects of group 1 (n=8) had a strict diet program composed of daily intake of less than 15% of fat and less than 100㎎ cholesterol; subjects of group 2 (n=6) had a usual diet program (American Heart Association step 1 diet) with daily intake of less than 30% fat and less than 300㎎ of cholesterol. All subjects were recommended with 200kcal per day exercise and instructed to stop cigarette smoking. Diet, anthropometric parameter, blood pressure measurements, serum lipid levels, and coronary angiography were recorded before and after the life-style modification program. Results: In group 1 (strict program) subjects, whose dietary intake of cholesterol and saturated fatty acid decreased, waist to hip circumference ratio and body fat decreased after the program. In contrast, there was no significant change in waist to hip circumference ratio and body fat of group 2 (usual program) subjects, whose dietary intake of cholesterol and saturated fatty acid did not decrease. In group 1, systolic blood pressure, serum total cholesterol and low density lipoprotein cholesterol levels decreased. There was no significant change in systolic blood pressure, serum total cholesterol, and low density lipoprotein cholesterol levels in group 2. Diameter stenosis of coronary artery regressed from 63.2±3.9% to 56.8±3.6% in group 1. There was no significant change (65.8±4.5% to 66.6±7.7%) in group 2. Conclusion: Coronary atherosclerosis significantly regressed in subjects who followed a strict life-style modification program, but not in subjects who continued their usual life-style program. Therefore, strict life-style change should be advised for coronary atherosclerotic patients.