A systematic review 1 including 63 studies with a total of 21,205 subjects was abstracted in DARE. Twenty-four studies (n=5,654) evaluated education or counselling combined with exercise, 23 studies (n=13,167) evaluated counselling or education without exercise, and 17 studies (n=2,566) evaluated exercise alone. Mortality. The overall RR of death was 0.85 (95% CI: 0.77 to 0.94). The overall RR varied with time of follow-up; it was not significant at 12 months (RR 0.97, 95% CI: 0.82 to 1.14), but was significant at 24 months (RR 0.53, 95% CI: 0.35 to 0.81) and 60 months (RR 0.77, 95% CI: 0.63 to 0.93). The benefit of interventions combining education and counselling with exercise was not statistically significant (RR 0.88, 95% CI: 0.74 to 1.04), whereas education and counselling alone (RR 0.87, 95% CI: 0.76 to 0.99) and exercise alone (RR 0.72, 95% CI: 0.54 to 0.95) showed benefits. Incidence of myocardial infarction. The overall RR myocardial infarction was 0.83 (95% CI: 0.74 to 0.94). The benefit of interventions combining education and counselling with exercise was statistically significant (RR 0.62, 95% CI: 0.44 to 0.87), whereas education and counselling alone (RR 0.86, 95% CI: 0.72 to 1.03) and exercise alone (RR 0.76, 95% CI: 0.57 to 1.01) did not show statistically significant benefits.
Comment: The majority of included participants were relatively young male patients.
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