Lifestyle modification for secondary prevention of atherosclerotic cardiovascular events

Lifestyle modification to reduce the risk of atherosclerotic cardiovascular events is critical to the long-term survival of patients with established atherosclerotic cardiovascular disease (ASCVD). The benefits of lifestyle modification for patients with ASCVD should not be underestimated and should be given equal emphasis to drug therapy. Smoking cessation alone is associated with a 36% reduction in the risk of all-cause mortality in patients with ASCVD. A healthy diet, regular exercise, weight management and reduced alcohol intake confer additional benefit. Consider other risk factors such as sleep disorders, mental illness or recreational drug use, which are associated with poorer cardiovascular outcomes.

Educate patients about the substantial benefits of leading a healthy lifestyle, and the need for changes to be maintained long term. Refer patients to specialised services if appropriate (eg dietitian, exercise physiologist) and provide ongoing support and advice to facilitate long-term change. Cardiac rehabilitation programs improve morbidity, mortality and quality of life following a cardiovascular event or diagnosis of ASCVDWoodruffe, 2015.

For more detailed advice, see Modifiable lifestyle risk factors for atherosclerotic cardiovascular disease and Smoking cessation.