Partners for Life: a theoretical approach to developing an intervention for cardiac risk reduction.

Long-term maintenance of behavioral change to reduce health risk factors is essential to producing a positive effect on medical outcomes. This study examines whether an ongoing, long-term relationship can be used to help patients diagnosed with coronary artery disease adhere to a risk-reducing behavioral intervention and maintain healthy behavioral changes. One hundred and sixty patients with diagnosed coronary artery disease will be randomized to a standard behavioral treatment group or to a standard behavioral treatment group including a couples intervention and followed for 18 months. The treatment in both groups follows tenets of cognitive behavioral and Self-Determination Theories as well as the Transtheoretical Model of Behavior Change. In addition, the couples intervention is designed to (1) change the patient's environment to facilitate cardiac risk-reducing behavioral changes, (2) optimize social reinforcement and motivation for behavior change, and (3) decrease relationship stress. Behavioral outcomes assessed include adherence to an exercise regimen, adherence to dietary recommendations and adherence to lipid-lowering medication. Lipid values, psychological variables and relationship variables are assessed throughout the study and at follow-up. While we expect both groups of cardiac patients to successfully adapt new health behaviors, we expect the couples intervention to be superior in helping maintain long-term health behaviors.

Postprandial changes in plasma and serum viscosity and plasma lipids and lipoproteins after an acute test meal.

The influence of a fat-rich test meal on postprandial changes in plasma viscosity and serum viscosity was assessed in 12 normolipidemic adults. After a 12-14-h fast, volunteers (five men and seven women aged 23-50 y) were challenged with a test milk shake containing 50 g fat/m2 body surface area (BSA). Plasma viscosity, serum viscosity, and plasma lipids and lipoproteins were assessed at 0, 2, 3, 4, and 6 h. Viscosity values were determined by using a Mettler Contraves LS-40 rotational microviscometer. Postprandial changes in the study variables were assessed by area under the curve and included triacylglycerols (2.02 mmol/L), plasma viscosity (-0.10 mPa.s), and serum viscosity (-0.01 mPa.s). Peak plasma triacylglycerol concentrations were significantly greater than those observed at baseline (P = 0.0022). There were no significant changes in any other variable when fasting and peak values were compared. Peak plasma viscosity increased in three and decreased in two subjects with no changes in the remaining seven subjects. Changes in peak plasma viscosity ranged from -7% to 7% with similar changes for serum viscosity, from -8% to 10%, and a slightly greater range for plasma fibrinogen, -16% to 10%. In this cohort of normotriacylglycerolemic subjects, there were no significant postprandial changes in plasma viscosity or serum viscosity.