Abstract WMP52: Sustained Long Term Lifestyle Modifications Regress Carotid Artery Atherosclerosis - Insights from a Meta-Analysis

Abstract

Background and Purpose: Carotid artery plaque progression has been associated with significant cerebrovascular morbidity and mortality. Even though, lifestyle modifications are the cornerstone of the management of atherosclerotic disease, the long term effects of a healthy diet and regular exercise on the atherosclerotic burden of carotid arteries is not clear. This meta-analysis was undertaken to assess this possibility. Methods: Randomized controlled trials comparing the efficacy of intensive lifestyle measures (diet and/or exercise) and usual care were identified by a systematic search. Three independent researchers searched MEDLINE, OVid, PUBMED, EMBASE and CINAHL for eligible studies. We included studies which provided baseline and quantitative carotid intimal medial thickness (IMT) data measured after at least 3 years. Comprehensive Meta-Analysis Version 2.0 was used for statistical analysis. Results: We identified 4 eligible studies of which 2 studies looked at the effect of diet alone while 1 looked at the effect of diet and exercise. One study was excluded from the analysis because of lack of sufficient data. There was no significant heterogeneity between the 3 studies analyzed (p: 0.699). A total of 980 patients were analyzed; 492 patients in the intervention group and 488 patients in the control group. After at least 3 years of follow up, lifestyle changes were negatively correlated with carotid IMT with a difference of mean of -0.023; SE: 0.007 (95% CI: -0.036 to -0.010, p: 0.001 ) when compared with the control group, reflecting the pooled effect size (Figure). Conclusion: Sustained long terms lifestyle changes i.e. diet and exercise, not only prevent the progression but also regress carotid artery atherosclerosis after at least three years of follow up.