Standard of care (control) group
Patients randomized to the control group will be managed according to current guidelines [Study procedures in the control and intervention groupsStudy Investigators perform a 20-min speech with patient and relatives about the major issues related to a heart-healthy lifestyle with some suggestions as follows: Healthy food choices: including vegetables, fruit, cereals, and water; avoiding foods containing saturated fat, foods and beverages with added sugars and salty foods; replacing saturated fat with monounsaturated and polyunsaturated fats from vegetables (oleic acid as in olive oil and rapeseed oil) and marine sources Weight control: to achieve and maintain a body mass index between 18.5 and 24.9 kg/m Smoking cessation Stress management: encouraging help from relatives and care givers Aerobic physical activity: aerobic physical activity such as walking and cycling; at least 20 min on 5 days/week should be engaged in physical activity; association of some calisthenic exercises, calibrating breathes and movements (description and teaching of 3 types of exercises) General recommendations: stairs rather than lift should be preferred; getting off the bus one stop earlier and walking for the rest of the way; going out for a walk with friends; for short trips, walking should be preferredEach participant receives dedicated brochures summarizing information and recommendations Individual counselling with nutritionist Weight control Intensive management of CV and metabolic risk factors Dedicated smoking cessation programs Exercise intervention: the patient starts walking on the level at 2.0 km/h or lower according to perceived exertion for the first time. Every 30 s the study physician increases of 0.3 km/h up to a walking speed corresponding to a perceived exertion of 11–13 on the Borg scale for 1 km. Every 2 min, the study physician records the rate of perceived exertion Identification and description of the tailored home-based program Description and indication of exercises derived from Otago Exercise Program Discussion about healthy food choice and compliance with diet Weight control Intensive management of CV and metabolic risk factors Discussion about compliance with medical therapy Exercise intervention: the patient starts walking at an updated intensity compared to the previous activity session. Every 30 s the study physician increases of 0.3 km/h up to a walking speed corresponding to a perceived exertion of 11–13 on the Borg scale for 1 km. Every 2 min, the study physician records the rate of perceived exertion Update and description of the tailored home-based program Description and indication of exercises derived from Otago Exercise Program