The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology

Journal of the American College of Cardiology

Volumn 45, Issue 5, 2005, Pages 637-651

  Rozanski, Alan ^a,f   Blumenthal, James A ^b   Davidson, Karina W ^c   Saab, Patrice G ^d   Kubzansky, Laura ^e  

^a Columbia Univ Coll Phys Surgs ^*  (United States)

^b DUKE UNIVERSITY MEDICAL CENTER   (United States)

^c MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^d Department of Biology   (United States)

^e HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^f ST LUKE S ROOSEVELT HOSPITAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDEPRESSANT AGENT; GLUCOCORTICOID; HYDROCORTISONE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; SEROTONIN TRANSPORTER; SERTRALINE; TRICYCLIC ANTIDEPRESSANT AGENT;

ANXIETY; ANXIETY DISORDER; BEHAVIOR THERAPY; BEHAVIORAL MEDICINE; CARDIOLOGY; CHRONICITY; CLINICAL TRIAL; CLUSTER ANALYSIS; COGNITIVE THERAPY; COMPARATIVE STUDY; CORONARY ARTERY DISEASE; CORONARY RISK; DEPRESSION; DISEASE ASSOCIATION; DISEASE COURSE; DISTRESS SYNDROME; EMOTION; EPIDEMIOLOGICAL DATA; EXERCISE; HEALTH CARE DELIVERY; HEALTH EDUCATION; HEART INFARCTION; HEART PROTECTION; HEART REHABILITATION; HUMAN; HYDROCORTISONE RELEASE; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; INTERMETHOD COMPARISON; LIFESTYLE; LONELINESS; MAJOR DEPRESSION; MARRIAGE; MEDICAL RESEARCH; MEDICAL SPECIALIST; META ANALYSIS; NONHUMAN; NUTRITION; PATHOPHYSIOLOGY; PATIENT COMPLIANCE; PATIENT COUNSELING; PATIENT REFERRAL; PRACTICE GUIDELINE; PRIORITY JOURNAL; PSYCHOLOGICAL ASPECT; PSYCHOPHARMACOTHERAPY; PSYCHOSOCIAL CARE; RELAXATION TRAINING; REVIEW; RISK ASSESSMENT; RISK FACTOR; SCREENING; SOCIAL ISOLATION; SOCIAL PSYCHOLOGY; SOCIAL STATUS; SOCIAL SUPPORT; STRESS; WORK;

EID: 14044256414     PISSN: 07351097     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jacc.2004.12.005     Document Type: Review

References (112)

1. A. Rozanski, J.A. Blumenthal, J. Kaplan Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy Circulation 99 1999 2192 2217
2. F. Lesperance, N. Frasure-Smith, M. Talajic, M.G. Bourassa Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction Circulation 105 2002 1049 1053
3. R. Rugulies Depression as a predictor for coronary heart disease. a review and meta-analysis Am J Prev Med 23 2002 51 61
4. K.A. Matthews, B.B. Gump, K.F. Harris, T.L. Haney, J.C. Barefoot Hostile behaviors predict cardiovascular mortality among men enrolled in the Multiple Risk Factor Intervention Trial Circulation 109 2004 66 70
5. Y. Matsumoto, O. Uyama, S. Shimizu, H. Michishita, R. Mori, T. Owada, M. Sugita Do anger and aggression affect carotid atherosclerosis? Stroke 24 1993 983 986
6. J. Julkunen, R. Salonen, G.A. Kaplan, M.A. Chesney, J.T. Salonen Hostility and the progression of carotid atherosclerosis Psychosom Med 56 1994 519 525
7. K.A. Matthews, J.F. Owens, L.H. Kuller, K. Sutton-Tyrrell, L. Jansen-McWilliams Are hostility and anxiety associated with carotid atherosclerosis in healthy postmenopausal women? Psychosom Med 60 1998 633 638
8. S.S. Knox, A. Adelman, R.C. Ellison Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study Am J Cardiol 86 2000 1086 1089
9. P. Angerer, U. Siebert, W. Kothny, D. Muhlbauer, H. Mudra, C. von Schacky Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis J Am Coll Cardiol 36 2000 1781 1788
10. R.B. Case, A.J. Moss, N. Case Living alone after myocardial infarction JAMA 267 1992 515 519
11. R.B. Williams, J. Barefoot, R. Califf Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease JAMA 267 1992 520 524
12. W. Ruberman, E. Weinblatt, J. Goldberg Psychosocial influences on mortality after myocardial infarction N Engl J Med 311 1984 552 559
13. L.F. Berkman, L. Leo-Summers, R.I. Howwitz Emotional support and survival after myocardial infarction: a prospective, population-based study of the elderly Ann Intern Med 117 1992 1003 1009
14. Gorkin L, Schron EB, Brooks MM, et al Psychosocial predictors of mortality in the cardiac Arrhythmia Suppression Trial-1 (CAST-1) Am J Cardiol 71 1993 263 267
15. N. Frasure-Smith, F. Lesperance, G. Gravel Social support, depression, and mortality during the first year after myocardial infarction Circulation 101 2000 1919 1924
16. T.E. Seeman, L. Syme Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease Psychosom Med 49 1987 341 354
17. M.G. Marmot, H. Bosma, H. Hemingway, E. Brunner, S. Stansfeld Contribution of job control and other risk factors to social variations in coronary heart disease incidence Lancet 350 1997 235 239
18. A. Baum, J.P. Garofalo, A.M. Yali Socioeconomic status and chronic stress: does stress account for SES effects on health? N. Adler M. Marmot B.S. McEwen J. Steward Socioeconomic Status and Health in Industrial Nations: Social, Psychological, and Biological Pathways, Annals of the New York Academy of Sciences 1999 New York Academy of Sciences New York, NY 131 144
19. R. Rosmond, P. Bjorntorp Occupational status, cortisol secretory pattern, and visceral obesity in middle-aged men Obesity Res 8 2000 445 450
20. R. Karasek, D. Baker, F. Marxer, A. Ahlbom, T. Theorell Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men Am J Public Health 71 1981 694 705
21. J. Siegrist Adverse health effects of high-effort/low-reward conditions J Occup Health Psychol 71 1996 694 705
22. J.V. Johnson, E.M. Hall, T. Theorell Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population Scand J Work Environ Health 15 1989 271 279
23. M. Kivimaki, P. Leino-Arjas, R. Luukkonen, H. Riihimaki, J. Vahtera, J. Kirjonen Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees (erratum appears in BMJ 2002;325:1386) BMJ 325 2002 857
24. J.V. Johnson, W. Stewart, E.M. Hall, P. Fredlund, T. Theorell Long-term psychosocial work environment and cardiovascular mortality among Swedish men Am J Public Health 86 1996 324 331
25. R. Peter, J. Siegrist, J. Hallqvist, C. Reuterwall, T. Theorell, S.S. Group Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP Study J Epidemiol Community Health 56 2002 294 300
26. A. Rosengren, S. Hawkin, S. Ounpuu Association of psychosocial risk factors with risk of acute myocardial infarction in 11,119 cases and 13,648 controls from 52 countries (the INTERHEART study): case-control study Lancet 364 2004 953 962
27. K.A. Matthews, B.B. Gump Chronic work stress and marital dissolution increase risk of posttrial mortality in men from the Multiple Risk Factor Intervention Trial Arch Intern Med 162 2002 309 315
28. P. Suadicani, H.O. Hein, F. Gyntelberg Are social inequalities associated with the risk of ischaemic heart disease a result of psychosocial working conditions? Atherosclerosis 101 1993 165 175
29. J. Lynch, N. Krause, G.A. Kaplan, R. Salonen, J.T. Salonen Workplace demands, economic reward, and progression of carotid atherosclerosis Circulation 96 1997 302 307
30. C. Muntaner, F.J. Nieto, L. Cooper, J. Meyer, M. Szklo, H.A. Tyroler Work organization and atherosclerosis: findings from the ARIC study Atherosclerosis Risk in Communities Am J Prev Med 14 1998 9 18
31. C.K. Nordstrom, K.M. Dwyer, C.N. Merz, A. Shircore, J.H. Dwyer Work-related stress and early atherosclerosis Epidemiology 12 2001 180 185
32. K. Orth-Gomer, S.P. Wamala, M. Horsten, K. Schenck-Gustafsson, N. Schneiderman, M.A. Mittleman Marital stress worsens prognosis in women with coronary heart disease: the Stockholm Female Coronary Risk Study JAMA 284 2000 3008 3014
33. J.C. Coyne, M.J. Rohrbaugh, V. Shoham, J.S. Sonnega, J.M. Nicklas, J.A. Cranford Prognostic importance of marital quality for survival of congestive heart failure Am J Cardiol 88 2001 526 529
34. L.C. Gallo, W.M. Troxel, L.H. Kuller Marital status, marital quality, and atherosclerotic burden in postmenopausal women Psychosom Med 65 2003 952 962
35. S. Lee, G.A. Colditz, L.F. Berkman, I. Kawachi Caregiving and risk of coronary heart disease in U.S women: a prospective study. Am J Prev Med 24 2003 113 119
36. R. Schulz, S.R. Beach Caregiving as a risk factor for mortality: the Caregiver Health Effects Study JAMA 282 1999 2215 2219
37. C. Schwartz, J.B. Meisenhelder, Y. Ma, G. Reed Altruistic social interest behaviors are associated with better mental health Psychosom Med 65 2003 778 785
38. H. Mausner-Dorsch, W.W. Eaton Psychosocial work environment and depression: epidemiologic assessment of the demand-control model Am J Public Health 90 2000 1765 1770
39. S. Batten, M. Aslan, P.K. Maciejewski, C.M. Mazure Childhood maltreatment as a risk factor for adult cardiovascular disease and depression J Clin Psychiatry 65 2004 249 254
40. D.J. Jones, J.T. Bromberger, K. Sutton-Tyrrell, K.A. Matthews Lifetime history of depression and carotid atherosclerosis in middle-aged women Arch Gen Psychiatry 60 2003 153 160
41. S.A. Everson, J.W. Lynch, M.A. Chesney Interaction of workplace demands and cardiovascular reactivity in progression of carotid atherosclerosis: population based study BMJ 314 1997 553 558
42. P.W. Wilson, R.B. D'Agostino, D. Levy, A.M. Belanger, H. Silbershatz, W.B. Kannel Prediction of coronary heart disease using risk factor categories Circulation 97 1998 1837 1847
43. S. Yusuf, S. Hawkin, S. Ounpuu Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study Lancet 364 2004 937 952
44. Rozanski A, Kubzansky LD. Psychological functioning and physical health: a paradigm of flexibility. Psychosom Med 2005. In press.
45. A.L. Goldberger Non-linear dynamics for clinicians: chaos theory, fractals, and complexity at the bedside Lancet 347 1996 1312 1314
46. R.M. Ryan, C. Frederick On energy, personality, and health: subjective vitality as a dynamic reflection of well-being J Pers 65 1997 529 565
47. J.J. Gross Antecedent- and response-focused emotion regulation: divergent consequences for experience, expression, and physiology J Pers Social Psychol 74 1998 224 237
48. Bonanno GA, Papa A, O'Neil K, Westphal M, Coifman K. The importance of being flexible: the ability to enhance and suppress emotional expression predicts long-term adjustment. Psychol Sci 2004;15:482-7.
49. I.J. Kant, U. Bultmann, K.A.P. Schroer, A.J.H.M. Beurskems, L.G.P.M. Van Amelsvoort, G.M.H. Swaen An epidemiological approach to study fatigue in the working population: the Maastricht cohort study Occup Environ Med 23; 2003 60 i32-9
50. B.L. Fredrickson, R.W. Levenson Positive emotions speed recovery from the cardiovascular sequelae of negative emotions Cogn Emotion 12 1998 191 220
51. K.A. Lawler, J.W. Younger, R.L. Piferi A change of heart: cardiovascular correlates of forgiveness in response to interpersonal conflict J Behav Med 26 2003 373 393
52. W. Gerin, C. Pieper, R. Levy, T.G. Pickering Social support in social interaction: a moderator of cardiovascular reactivity Psychosom Med 54 1992 324 336
53. S. Cohen, W.J. Doyle, R.B. Turner, C.M. Alper, D.P. Skoner Emotional style and susceptibility to the common cold Psychosom Med 65 2003 652 657
54. L.D. Kubzansky, D. Sparrow, P. Vokonas, I. Kawachi Is the glass half empty or half full? A prospective study of optimism and coronary heart disease in the normative aging study Psychosom Med 63 2001 910 916
55. M.F. Scheier, K.A. Matthews, J.F. Owens Optimism and rehospitalization after coronary artery bypass graft surgery Arch Intern Med 159 1999 829 835
56. D.D. Danner, D.A. Snowdon, W.V. Friesen Positive emotions in early life and longevity: findings from the nun study J Pers Social Psychol 80 2001 804 813
57. Carney RM, Freedland KE, Veith RC. Depression, the autonomic nervous system, and coronary heart disease. Psychosom Med 2005. In press.
58. B. Weber-Hamann, F. Hentschel, A. Kniest Hypercortisolemic depression is associated with increased intra-abdominal fat Psychosom Med 64 2002 274 277
59. M. De Groot, R. Anderson, K.E. Freedland, R.E. Clouse, P.J. Lustman Association of depression and diabetes complications: a meta-analysis Psychosom Med 63 2001 619 630
60. 2A receptor as missing link? Psychosom Med 65 2003 729 737
61. H. Anisman, Z. Merali Cytokines, stress, and depressive illness Brain Behav Immun 16 2002 513 524
62. K. Esposito, F. Nappo, R. Marfella Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress Circulation 106 2002 2067 2072
63. S. Rajagopalan, R. Brook, M. Rubenfire, E. Pitt, E. Young, B. Pitt Abnormal brachial artery flow-mediated vasodilation in young adults with major depression (erratum appears in Am J Cardiol 2001;88:722) Am J Cardiol 88 2001 196 198
64. P.M. McCabe, J.A. Gonzales, J. Zaias Social environment influences the progression of atherosclerosis in the Watanabe heritable hyperlipidemic rabbit Circulation 105 2002 354 359
65. S.L. McElroy, R. Kotwal, S. Malhotra, E.B. Nelson, P.E. Keck Jr, C.B. Nemeroff Are mood disorders and obesity related? A review for the mental health professional J Clin Psychiatry 65 2004 634 651
66. M.F. Dallman, S. La Fluer, N.C. Pecoraro, F. Gomez, H. Houshyar, S.F. Akana Minireview: glucorcorticoids--food intake, abdominal obesity, and wealthy nations in 2004 Endocrinology 145 2004 2633 2638
67. S. Bhatnagar, M. Dallman Neuroanatomical basis for facilitation of hypothalamic-pituitary-adrenal responses to a novel stressor after chronic stress Neuroscience 84 1998 1025 1039
68. S.E. Lindley, T.G. Bengoechea, A.F. Schatzberg, D.L. Wong Glucocorticoid effects on mesotelencephalic dopamine neurotransmission Neuropsychopharmacology 21 1999 399 407
69. 2 receptors and cocaine self-administration Nature Neurosci 5 2002 169 174
70. N.D. Volkow, G.J. Wang, J.S. Fowler "Nonhedonic" food motivation in humans involves dopamine in the dorsal striatum and methylphenidate amplifies this effect Synapse 44 2002 175 180
71. G.J. Wang, N.D. Volkow, J. Logan Brain dopamine and obesity Lancet 357 2001 354 357
72. T.W. Kamarck, S.A. Everson, G.A. Kaplan Exaggerated blood pressure responses during mental stress are associated with enhanced carotid atherosclerosis in middle-aged Finnish men: findings from the Kuopio Ischemic Heart Disease Study Circulation 96 1997 3842 3848
73. K.A. Matthews, J.F. Owens, L.H. Kuller, K. Sutton-Tyrrell Stress induced pulse pressure change predicts women's carotid atherosclerosis Stroke 29 1998 1525 1530
74. E.C. Suarez, C.M. Kuhn, S.M. Schanberg, R.B. Williams Jr, E.A. Zimmermann Neuroendocrine, cardiovascular, and emotional responses of hostile men: the role of interpersonal challenge Psychosom Med 60 1998 78 88
75. A.J. Grippo, J.A. Moffitt, A.K. Johnson Cardiovascular alterations and autonomic imbalance in an experimental model of depression Am J Physiol 282 2002 R1333 R1341
76. K.D. Laugero, F. Gomez, S. Manalo, M. Dallman Corticosterone infused intracerebroventricularly inhibits energy storage and stimulates the hypothalamo-pituitary axis in adrenalectomized rats drinking sucrose Endocrinology 143 2002 4552 4562
77. D.A. Scheuer, A.G. Bechtold, S.S. Shank, S.F. Akana Glucocorticoids act in the dorsal hindbrain to increase arterial pressure Am J Physiol 286 2004 H458 H467
78. D.A. Scheuer, A.G. Bechtold Activation of dorsal hindbrain glucocorticoid receptors enhances the arterial pressure response to acute stress (abstr) FASEB J 18 2004 A675
79. R.C. Kessler, K.A. McGonagle, S. Zhao Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey Arch Gen Psych 51 1994 8 19
80. R.P. Fleet, G. Dupuis, A. Marchand, J. Kaczorowski Panic disorder in coronary artery disease patients with noncardiac chest pain J Psychosom Res 44 1998 81 90
81. L.J. Kirmayer, J.M. Robbins, M. Dworkin, M.J. Yaffe Somatization and the recognition of depression and anxiety in primary care Am J Psychiatry 150 1993 734 741
82. W.J. Katon, M. Von Korff, E. Lin Panic disorder: relationship to high medical utilization Am J Med 92 Suppl 1A 1992 7S 11S
83. R.P. Fleet, G. Dupuis, A. Marchand, D. Burelle, A. Arsenault, B.D. Beitman Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition Am J Med 101 1996 371 380
84. M.R. DiMatteo, H.S. Lepper, T.W. Croghan Depression is a risk factor for noncompliance with medical treatment Meta-analysis of the effects of anxiety and depression on patient adherence Arch Intern Med 160 2000 2101 2107
85. M.R. DiMatteo Social support and patient adherence to medical treatment: a meta-analysis Health Psychol 23 2004 207 218.
86. Neugarten BJ. Adult personality: towards a psychology of the life cycle. In: Neugarten BL, editor. Middle Age and Aging. Chicago, IL: University of Chicago Press, 1968.
87. M.A. Whooley, G.E. Simon Managing depression in medical outpatients N Engl J Med 343 2000 1942 1950
88. S.K. Joos, D.H. Hickam How health professionals influence health behavior: patient provider interaction and health care outcomes K. Glanz F.M. Lewis B.K. Rimer Health Behavior and Health Education: Theory Research and Practice 1990 Jossey-Bass San Fransisco, CA 216 241
89. N.H. Miller, M. Hill, T. Kottke, I.S. Ockene The multilevel compliance challenge: recommendations for a call to action A statement for healthcare professionals Circulation 95 1997 1085 1090
90. D.A. Lawlor, S.W. Hopker The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials Br Med J 322 2001 763 767
91. J.A. Blumenthal, M.A. Babyak, K.A. Moore Effects of exercise training on older patients with major depression Arch Intern Med 159 1999 2349 2356
92. M. Babyak, J.A. Blumenthal, S. Herman Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months Psychosom Med 62 2000 633 638
93. W. Linden, C. Stossel, J. Maurice Psychosocial interventions for patients with coronary artery disease: a meta analysis Arch Intern Med 156 1996 745 752
94. E. Dusseldorp, T. van Elderen, S. Maes, J. Meulman, V. Kraaij A meta-analysis of psychoeducational programs for coronary heart disease patients Health Psychol 18 1999 506 519
95. Carney RM, Blumenthal JA, Freedland KE, et al. Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) Study. Psychosom Med 2004;66:466-74.
96. M. Friedman, C.E. Thoresen, J. Gill Alteration of type A behavior and its effect on cardiac recurrences in postmyocardial infarction patients: summary results of the Recurrent Coronary Prevention Project Am Heart J 112 1986 653 665
97. N. Frasure-Smith, R. Prince The ischemic heart disease life stress monitoring program: impact on mortality Psychosom Med 47 1985 431 445
98. D.A. Jones, R.R. West Psychological rehabilitation after myocardial infarction: multicenter randomized control trial Br Med J 313 1996 1517 1521
99. N. Frasure-Smith, F. Lesperance, R.H. Prince Randomized trial of home-based psychosocial nursing intervention for patients recovering from myocardial infarction Lancet 350 1997 473 479
100. S. Cossette, N. Frasure-Smith, F. Lesperance Clinical implications of a reduction in psychological distress on cardiac prognosis in patients participating in a psychosocial intervention program Psychosom Med 63 2001 257 266
101. The ENRICHD Investigators Effects of treating depression and low perceived social support on clinical events after a myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial JAMA 289 2003 3106 3116
102. A.H. Glassman, C.M. O'Connor, R.M. Califf Setraline treatment of major depression in patients with acute MI or unstable angina JAMA 288 2002 701 709
103. H.W. Cohen, G. Gibson, M.H. Alderman Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents Am J Med 108 2000 2 8
104. W.H. Sauer, J.A. Berlin, S.E. Kimmel Selective serotonin reuptake inhibitors and myocardial infarction Circulation 104 2001 1894 1898
105. F. Lesperance, N. Frasure-Smith, P. Theroux, M. Irwin The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes Am J Psychiatry 161 2004 271 277
106. P.A. Ades Cardiac rehabilitation and secondary prevention of coronary heart disease N Engl J Med 345 2001 892 902
107. W. Katon, M. Von Korff, E. Line, G. Simon Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial Arch Gen Psychiatry 56 1999 119 1115
108. W.J. Katon, P. Roy-Byrne, J. Russo, D. Cowley Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder Arch Gen Psychiatry 59 2002 1098 1104
109. A.J. Bellg Maintenance of health behavior change in preventative cardiology: internalization and self-regulation of new behaviors Behav Modif 27 2003 103 131
110. G.C. Williams, G.C. Rodin, R.M. Ryan, W.S. Grolnick, E.L. Deci Autonomous regulation and long-term medication adherence in adult outpatients Health Psychol 17 1998 269 276
111. W.R. Miller, S. Rollnick Motivational Interviewing: Preparing People To Change Addictive Behavior 1991 Guilford New York, NY
112. P.G. O'Malley, I.M. Feuerstein, A.J. Taylor Impact of electron beam tomography, with and without case management, on motivation, behavioral change, and cardiovascular risk profile A randomized controlled trial JAMA 289 2003 2215 2223