PT  - JOURNAL ARTICLE
AU  - Andrew Wister, PhD
AU  - Nadine Loewen MD
AU  - Holly Kennedy-Symonds, MHSc
AU  - Brian McGowan MD
AU  - Bonnie McCoy, MA
AU  - Joel Singer, PhD
TI  - One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk
AID  - 10.1503/cmaj.061059
DP  - 2007 Oct 09
TA  - Canadian Medical Association Journal
PG  - 859--865
VI  - 177
IP  - 8
4099  - http://www.cmaj.ca/content/177/8/859.short
4100  - http://www.cmaj.ca/content/177/8/859.full
SO  - CMAJ2007 Oct 09; 177
AB  - 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].)