A health educator-led intervention did not improve total to HDL cholesterol ratio but increased physical activity by 23.9 mins/week and fruit/vegetable intake in family members of CAD patients.
RCT (n=426)
Single-blind
Stratified randomization based on relation to index patient with 1:1 allocation
No
Does a family heart-health intervention improve lipid profiles and lifestyle behaviors in family members of patients with CAD?
A health educator-led intervention improved self-reported physical activity and diet but did not significantly alter the total cholesterol to HDL cholesterol ratio in family members of CAD patients.
Effect estimate: Mean difference 23.9 (95% CI 3.9-44.0)
Absolute Event Rate: 142.5% vs 118.6%
p-value: p=0.03
BACKGROUND: Family members of patients with coronary artery disease (CAD) have higher risk of vascular events. We conducted a trial to determine if a family heart-health intervention could reduce their risk of CAD. METHODS: We assessed coronary risk factors and randomized 426 family members of patients with CAD to a family heart-health intervention (n = 211) or control (n = 215). The intervention included feedback about risk factors, assistance with goal setting and counselling from health educators for 12 months. Reports were sent to the primary care physicians of patients whose lipid levels and blood pressure exceeded threshold values. All participants received printed materials about smoking cessation, healthy eating, weight management and physical activity; the control group received only these materials. The main outcomes (ratio of total cholesterol to high-density lipoprotein HDL cholesterol; physical activity; fruit and vegetable consumption) were assessed at 3 and 12 months. We examined group and time effects using mixed models analyses with the baseline values as covariates. The secondary outcomes were plasma lipid levels (total cholesterol, low-density lipoprotein cholesterol, HDL cholesterol and triglycerides); glucose level; blood pressure; smoking status; waist circumference; body mass index; and the use of blood pressure, lipid-lowering and smoking cessation medications. RESULTS: We found no effect of the intervention on the ratio of total cholesterol to HDL cholesterol. However, participants in the intervention group reported consuming more fruit and vegetables (1.2 servings per day more after 3 mo and 0.8 servings at 12 mo; p < 0.001). There was a significant group by time interaction for physical activity (p = 0.03). At 3 months, those in the intervention group reported 65.8 more minutes of physical activity per week (95% confidence interval CI 47.0-84.7 min). At 12 months, participants in the intervention group reported 23.9 more minutes each week (95% CI 3.9-44.0 min). INTERPRETATION: A health educator-led heart-health intervention did not improve the ratio of total cholesterol to HDL cholesterol but did increase reported physical activity and fruit and vegetable consumption among family members of patients with CAD. Hospitalization of a spouse, sibling or parent is an opportunity to improve cardiovascular health among other family members. TRIAL REGISTRATION: clinicaltrials.gov, no NCT00552591.
Reid et al. (Mon,) conducted a rct in Family members of patients with coronary artery disease (CAD) with at least 1 modifiable risk factor (n=426). Family heart-health intervention vs. Control (printed materials and physician notification) was evaluated on Weekly minutes of moderate and vigorous physical activity at 12 months (Mean difference 23.9, 95% CI 3.9-44.0, p=0.03). A health educator-led intervention did not improve total to HDL cholesterol ratio but increased physical activity by 23.9 mins/week and fruit/vegetable intake in family members of CAD patients.