A lifestyle intervention with telephone counselling significantly reduced the Framingham risk score compared to usual care in primary prevention patients (-3.10 vs -1.30; P<0.01).
RCT (n=611)
Absolute Event Rate: -3.1% vs -1.3%
p-value: p=<0.01
BACKGROUND: In this study, we tested the efficacy of a low-intensity lifestyle intervention aimed at reducing the risk of cardiovascular disease among mid-life individuals. METHODS: We conducted a randomized controlled trial in which participants were randomly assigned either to receive a health report card with counselling (from a Telehealth nurse) on smoking, exercise, nutrition and stress or to receive usual care. The patients were divided into 2 groups on the basis of risk: the primary prevention group, with a Framingham risk score of 10% or higher (intervention, n = 157; control, n = 158), and the secondary prevention group, who had a diagnosis of coronary artery disease (intervention, n = 153; control, n = 143). The primary outcome was a change in the Framingham global risk score between baseline and 1-year follow-up. Data were analyzed separately for the 2 prevention groups using an intention-to-treat analysis controlling for covariates. RESULTS: Within the primary prevention group, there were statistically significant changes for the treatment group relative to the controls, from baseline to year 1, in Framingham score (intervention, -3.10 95% confidence interval (CI) -3.98 to -2.22; control, -1.30 95% CI -2.18 to -0.42; p < 0.01) and scores for total cholesterol (intervention, -0.41 95% CI -0.59 to -0.23; control, -0.14 95% CI -0.32 to 0.04; p < 0.05), systolic blood pressure (intervention, -7.49 95% CI -9.97 to -5.01; control, -3.58 95% CI -6.08 to -1.08; p < 0.05), nutrition level (intervention, 0.30 95% CI 0.13 to 0.47; control, -0.05 95% CI -0.22 to 0.12; p < 0.01), and health confidence (intervention, 0.20 95% CI 0.09 to 0.31; control, 0.04 95% CI -0.07 to 0.15; p < 0.05), with adjustment for covariates. No significant changes in outcome variables were found for the secondary prevention group. INTERPRETATION: We found evidence for the efficacy of an intervention addressing multiple risk factors for primary prevention at 1 year using Framingham risk score report cards and telephone counselling. (Requirement for clinical trial registration waived enrolment completed before requirement became applicable.).
Wister et al. (Mon,) conducted a rct in Cardiovascular disease risk (n=611). Health report card with telephone counselling on smoking, exercise, nutrition and stress vs. Usual care was evaluated on Change in the Framingham global risk score between baseline and 1-year follow-up (p=<0.01). A lifestyle intervention with telephone counselling significantly reduced the Framingham risk score compared to usual care in primary prevention patients (-3.10 vs -1.30; P<0.01).
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