The particular R428-Program

Measures The primary outcome is a composite including improvement of at least one of the following 3 cardiac risk factors at baseline, 3, 6, and 12 months (1) physical activity (at least 150 minutes per week), (2) diet (consumption of five or more fruits and vegetables daily), and (3) smoking (complete cessation for baseline smokers, maintained nonsmoking Selleck JQ1 status for baseline nonsmokers). Secondary outcomes will include improvement in all 3 cardiac risk factors, intention and self efficacy to achieving lifestyle change [41,44,45], change in exercise capacity by peak oxygen uptake (VO2), change in weight (��5% weight reduction for patients with baseline BMI >30 kg/m2), blood pressure optimization (blood pressure E-64 physical activity data will be obtained from personal activity trackers as number of steps per day [48]. All patients will undergo a symptom-limited ETT with oxygen consumption testing to assess for peak VO2 [52,53]. Continuous blood pressure and heart rate measurements, as well as electrocardiograms will be obtained during exercise and recovery periods. A brief dietary recall by a food frequency questionnaire will allow for diet evaluation [42]. Mayo Clinic laboratories will process and analyze all fasting blood specimens including lipid panel (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol), blood glucose, and hemoglobin A1c. Physical examination measures including R428 in vivo height, weight, body mass index, waist circumference, and blood pressure will be obtained according to standard guidelines and Mayo Clinic protocols [54-55]. The baseline questionnaires and clinical assessments will be repeated at 3, 6, and 12 months (study completion). At program completion, we also plan to have semi-structured focus groups to solicit feedback on the intervention and control rehabilitation programs. We anticipate holding at least two sessions (one for each study group) with at least 20 participants per session. We will collect information on participant experiences, attitudes, and beliefs on healthy lifestyle change through open-ended intervention questions developed by the research team.