Les objectifs comportementaux du patient coronarien : ne plus fumer, manger mieux, bouger plus et mieux

Abstract : The behavioral goals of the coronary patient require active management by the cardiologist. Every smoker must be clearly informed about the cardiovascular consequences of smoking and the major benefits of smoking cessation. The only advice to "quit smoking" is not enough. Validated "treatments" (cognitive-behavioral therapy, nicotine replacement therapy, varenicline, bupropion) must be used, with a precise strategy and prolonged follow-up. All drugs assistance can be prescribed in coronary patients and nicotine replacement therapy can even be used just after a myocardial infarction. Nutrition plays a significant role in cardiovascular prevention. Counseling today is based on solid evidence, although evidence is harder to obtain than with drugs. It should no longer be advisable only to "suppress cooked fats and starches" because these recommendations are unclear and/or false. Today we need positive food-based benchmarks and complex dietary patterns in which fruits and vegetables, fish, whole grains, pulses, nuts, olive oil and a diet closed to the Mediterranean diet. Dairy products have their place. Sugary foods should be limited especially in case of overweight and metabolic syndrome. Physical activity is part of good nutrition. Indeed, the fight against a very sedentary lifestyle and physical inactivity in coronary and heart failure patients is part of the lifelong treatment of these patients. The cardiologist and the general practitioner must be much more involved in their prescription and education to hope for good compliance.
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Submitted on : Tuesday, October 23, 2018 - 4:21:27 PM
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D Thomas, F Paillard, J M Lecerf, F Carré. Les objectifs comportementaux du patient coronarien : ne plus fumer, manger mieux, bouger plus et mieux. Annales de Cardiologie et d'Angéiologie, Elsevier Masson, 2018, 67 (5), pp.352-360. ⟨10.1016/j.ancard.2018.08.010⟩. ⟨hal-01902639⟩



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