Behavioral approaches to secondary prevention of coronary heart disease.

Over the past 10 years behavioral approaches to the treatment of coronary heart disease (CHD) have become widely recognized as being a significant complement to traditional medical and surgical therapies. The success of approaches to secondary prevention now relate to quality, as well as quantity, of life. A multifaceted program, including dietary management, smoking cessation, physical exercise, modification of type A behavior, and psychological counseling are components of many cardiac rehabilitation programs. Behavioral interventions are effective in reducing traditional risk factors for CHD events, and for improving the quality of life among victims of a disease with significant psychological, as well as physical, consequences. However, the effectiveness of behavioral interventions for prolonging life is less certain and requires more careful evaluation. The mechanisms by which behavioral treatments may influence clinical CHD end points is also in need of further investigation.