Long-term management of the lifestyles of cardiac patients who have completed a cardiac rehabilitation program (CRP), and the risks that may develop for future health problems, have not been extensively reported. The purpose of this pilot study of graduates of CRPs was to: (a) assess lifestyle and risk factor trends, (b) test certain protocols, and (c) identify the challenges and limitations in managing lifestyles and risk factors. A convenience sample of 49 people with ischemic heart disease (IHD) was randomized to a Lifestyle Management Intervention (LMI) group and a Usual Care (UC) group and followed for 6 months. Patients assigned to the LMI group underwent six additional exercise sessions and participated in telephone follow-ups and a counseling session. Patients in the UC group were assessed at baseline and at the end of 6 months. Of the original 49 participants, 17 in the LMI group and 19 in the UC group completed the study. Patients in the LMI group showed significant reductions in total cholesterol and LDL-C from baseline at 6 months. Diastolic blood pressure was decreased significantly in the UC group. The study identified the challenges of lifestyle intervention and found that favorable risk factor modifications are possible for patients who have completed a CRP.