Counseling may help prevent heart attacks, say researchers

Researchers have discovered that a counseling program originally designed to promote regular walking has improved the quality of life for sufferers of blocked leg arteries and helped protect them from its deadly effects—but not in the way anticipated.

Professor Jonathan Golledge from James Cook University's College of Medicine and Dentistry led the study, that has been published in JAMA Surgery. He said that blocked leg arteries affect nearly one in five older Australian adults and are associated with a high risk of heart attack, stroke and death.

"We wanted to find out if four brief counseling sessions could encourage people with blocked leg arteries to walk, and examined this in a 200 patient randomized clinical trial," said Professor Golledge.

Just over half of the patients received two hour-long face-to-face sessions and two 15-minute telephone sessions, encouraging them towards walking goals of 40-minutes three times a week.

"They were monitored both physically and mentally. The intervention did not significantly improve their daily step count or change conventional cardiovascular risk factors.

"The counseling did improve participants' quality of life and remarkably halved the risk of heart attack, stroke and death. This effect was associated with a reduction in participants' anxiety and depression."

He said a part of the counseling focused on assisting participants to understand and self-manage the challenges of exercising with the leg pain caused by blocked leg arteries.

"It's possible this led to more acceptance and reduced psychological distress, which then led to less perceived physical disability and pain, and so to an improved quality of life and reduced risk of cardiovascular events," said Professor Golledge.

He said the scientists believed it was the first randomized clinical trial to show that a physical activity counseling intervention was associated with reduced risk of cardiovascular events—a finding which needed to be validated in larger trials.

"If validated, this would be a completely novel approach to reducing cardiovascular risk, which we think is super exciting," said Professor Golledge.

He said the team are now combining this counseling approach with tele-health exercise sessions, which they hope will improve walking as well as quality of life and powerfully reduce the risk of cardiovascular events.

"We urgently want patients with blocked arteries to join our trial to see if this is effective. Please contact us if you have blocked leg arteries and would like to take part," said Professor Golledge.