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June 7, 2026European Heart Journal

The Extensive Lifestyle Management Intervention (ELMI) following cardiac rehabilitation trial

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Key result

Extensive lifestyle management after cardiac rehab fails to improve cardiovascular risk scores versus usual care.

  • P=0.138 (Framingham), 0.089 (Procam)
  • n=302

Why the study?

Previous studies have reported lifestyle and risk factor deterioration following the completion of a cardiac rehabilitation program.

Does a one-year Extensive Lifestyle Management Intervention (ELMI) improve global cardiovascular risk in patients with ischaemic heart disease following completion of a cardiac rehabilitation program?

Population

302 men and women with ischaemic heart disease following completion of a cardiac rehabilitation program

Comparison

Extensive Lifestyle Management Intervention vs usual care

Design

Randomized controlled trial

Authors

SLScott A. LearPreventive Cardiology

Discussion

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Implication

Non-significant trends do not support ELMI for sustained post-CR risk reduction; leaves open whether intensified interventions can prevent deterioration.

Key Points

  • The aim is to examine the effectiveness of an Extensive Lifestyle Management Intervention (ELMI) in reducing cardiovascular risk after cardiac rehabilitation.
  • 302 individuals with ischaemic heart disease were randomized to either ELMI or usual care.
  • ELMI included exercise sessions, telephone follow-ups, and risk factor/lifestyle counseling.
  • Primary outcome assessed was global cardiovascular risk using Framingham and Procam risk scores.
  • ELMI showed a non-significant reduction in the Framingham score (P=0.138).
  • Procam score showed a non-significant trend (P=0.089) compared to usual care.
  • No significant differences in secondary outcomes between groups.

Study Design

Type

RCT (n=302)

Structured PICO

Does a one-year Extensive Lifestyle Management Intervention (ELMI) improve global cardiovascular risk in patients with ischaemic heart disease following completion of a cardiac rehabilitation program?

P
Population
302 men and women with ischaemic heart disease who had completed a cardiac rehabilitation program, followed for one year.
I
Intervention
One-year Extensive Lifestyle Management Intervention (ELMI) consisting of exercise sessions, telephone follow-ups, and risk factor and lifestyle counselling
C
Comparator
Usual care
O
Outcome
Global cardiovascular risk using the Framingham and Procam risk scoressurrogate

Main Result

p-value: p=0.138 (Framingham), 0.089 (Procam)

A one-year multi-factorial post-cardiac rehabilitation lifestyle intervention resulted in modest, non-significant benefits to global cardiovascular risk compared to usual care.

Limitations

  • Improved practices in usual care may have prevented expected deterioration in the control group

Cite This Study

Scott A. Lear (2003) conducted an RCT in ischaemic heart disease (n=302). Extensive Lifestyle Management Intervention (ELMI) vs. usual care was evaluated on global cardiovascular risk using the Framingham and Procam risk scores (p=0.138 (Framingham), 0.089 (Procam)). A one-year Extensive Lifestyle Management Intervention following cardiac rehabilitation yielded non-significant changes in Framingham (P=0.138) and Procam (P=0.089) risk scores compared to usual care.

synapsesocial.com/papers/6a258be8574e690f5ca04d14https://doi.org/10.1016/j.ehj.2003.08.015

Topics

Women and heart disease
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