A combined lifestyle and medication intervention to reduce CVD risk

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States. While lifestyle and medication use can substantially reduce CVD risk, both are underused. As about half of U.S. adults are seen by primary care clinicians each year, an effective intervention offered in this setting has great potential for public health impact.

Methods: This project combines previously tested lifestyle and medication interventions to reduce CVD risk and tests this combined intervention in two formats (counselor- vs. web-based) among a diverse group of patients enrolled at family practices in North Carolina. The two previously tested interventions are “A New Leaf…Choices for Healthy Living,” which emphasizes practical strategies to improve lifestyle and is given by a health counselor and “Heart to Heart”, a web-based tool that facilitates decision making about medications to reduce CVD risk and offers tailored messages to improve medication adherence. Participants are randomized to a counselor- or web-based intervention format. The primary outcome is the reduction in estimated 10-year risk of coronary heart disease. Secondary outcomes include change in dietary intake, physical activity, blood pressure, blood lipids, and medication use. Feasibility, acceptability, and cost-effectiveness will also be assessed.

Results: The lifestyle and medication interventions have been modified to be consistent with the current literature and combined into an integrated program offered in two formats: counselor- and web-based. At this session, the interventions will be described and baseline data reported.

Conclusions: Both interventions, which address lifestyle and medication, have the potential to substantially reduce CVD risk.