Rationale:

Emerging data have displayed important gender-based differences in the response to cardiovascular disease (CVD) therapies. Although national clinical guidelines promulgate therapeutic lifestyle changes (TLC) as a cornerstone in CVD risk reduction in both men and women, scarce comprehensive data are available on the effect of gender on responses to TLC.

Objectives:

In this study, we compared the clinical effectiveness of TLC in 2,144 consecutive men (n = 543; age = 47+/-10 years) and women (n = 1,601; age = 46+/-10 years) with an elevated blood pressure, LDL cholesterol, and/or fasting plasma glucose level who were not taking medication for hypertension, hyperlipidemia, or diabetes.

Methodology:

Subjects were evaluated at baseline and after approximately 12 weeks of participation in a community-based lifestyle management program. TLC included exercise training, nutrition, weight management, stress management, and smoking cessation interventions. All subjects remained off antihypertensive, antilipemic, and antidiabetic medications throughout the study.

Results:

Among subjects with abnormal baseline CVD risk factors (based on national guidelines), clinically relevant improvements (P <=.05) were observed for multiple variables, including: systolic/diastolic blood pressure (Men, -7/-6 mmHg; Women, -10/-7 mmHg; P <=.05 for Men versus Women); LDL cholesterol (Men, -18 mg/dl; Women, -11 mg/dl; P <=.05 for Men versus Women); HDL cholesterol (Men, 2 mg/dl; Women, 4 mg/dl; P = NS for Men versus Women); triglycerides (Men, -55 mg/dl; Women, -49 mg/dl; P = NS for Men versus Women); fasting glucose (Men, -10 mg/dl; Women, -9 mg/dl; P = NS for Men versus Women); and weight (Men, -7 lbs; Women, -5 lbs; P <=.05 for Men versus Women). In subjects with a calculated Framingham 10-year coronary heart disease risk score >=10% at baseline, the score decreased significantly (P <=.05) in men (-18.8%) and women (-18.9%); P = NS for Men versus Women.

Conclusions:

These data demonstrate the similar clinical effectiveness of TLC in men and women with an elevated blood pressure, LDL cholesterol, and/or fasting plasma glucose level.