Relationship between acute effects on cardiovascular risk in an immersive lifestyle medicine program

Background Although immersion in an intensive lifestyle intervention program has the potential to significantly modify risk factors associated with atherosclerotic cardiovascular disease (ASCVD), its acute effects on the immediate prevention of this condition have not been fully validated across different diseases and population subgroups. Purpose We aimed to evaluate the risk of atherosclerotic cardiovascular events in patients with type 2 diabetes (T2D), primary hypertension (HTN), and dyslipidemia (DLP), before and after the implementation of an intensive lifestyle intervention, taking into account the use or non-use of medications. Methods We conducted a retrospective, observational study with adherence-based selection to assess the effects of an intensive lifestyle modification program on ASCVD. The intervention, carried out in a specialized hotel setting, integrated a high-fiber, plant-based diet low in saturated fat with a 30–50% caloric restriction of the total energy value, and moderate-intensity aerobic and resistance exercise. The sample comprised individuals with T2D, HTN, and DLP (the latter undergoing statin therapy), compared using Kruskal-Wallis and Dunn tests. Assessments were performed at two time points (baseline and follow-up) with analysis via the Wilcoxon test based on data normality, considering an average stay of 13.43 days (95% CI: 11.77–15.08) and a maximum follow-up of 59 days. Furthermore, logistic regression was employed to identify predictors of favorable outcomes. Results The sample consisted of 128 participants (mean age 60.97 years; 60.94% women and 39.06% men; with 39.84% on statins and 7.8% on acetylsalicylic acid [ASA]), with a mean ASCVD of 14.68% (95% CI: 12.43–16.93) and a mean total cholesterol (TC) of 201.22 mg/dL (95% CI: 192.41–210.03). The Wilcoxon test revealed significant reductions: LDL decreased by 10.9% (p<0.001, mirroring the TC reduction), systolic blood pressure decreased by 6.6% (p<0.001), and HDL increased non-significantly by 2.2% (p=0.63). Rank-biserial correlations ranged from 0.519 to 0.854. Logistic regression indicated that each 1 mg/dL reduction in TC was associated with a 5.5% decrease in cardiovascular risk (OR = 0.945), resulting in an average ASCVD reduction of −21.00% (p<0.001). In the subgroup of patients on ASA, ASCVD reduction reached −34% (p<0.001), and among individuals over 60 years, the diabetic subgroup exhibited the greatest decrease at −17.7% (p<0.001). Kruskal-Wallis (χ² = 7.568; p = 0.109) and Dunn’s tests (p > 0.05) indicated that ASCVD reduction did not differ significantly among the evaluated clinical subgroups, regardless of sex and statin use. Conclusion The intensive intervention program proved effective in acutely reducing ASCVD, with significant impacts on lipid markers. The absence of differences in risk reduction among comorbidity-stratified groups reinforces its applicability across diverse clinical profiles, including middle-aged and elderly individuals.