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01 April 2008

Cardiovascular risk reduction and factors influencing loss to follow-up in the coronary health improvement project

Ray M. Merrill, Steven G. Aldana

Med Sci Monit 2008; 14(4): PH17-25 :: ID: 850307

Abstract

Background: This study determined whether the Coronary Health Improvement Project (CHIP) can improve cardiovascular disease risk factors through one year of follow-up and identified factors influencing loss to follow-up.
Material/Methods: The CHIP program, an intensive four week community-based health education intervention designed to improve coronary risk factors, was evaluated using a quasi-experimental design. Analyses were based on 1,712 community volunteers, ages 30 to 87 from the Rockford, Illinois Metropolitan area. Of the participants, 97.7% completed the lifestyle evaluation at both baseline and after four weeks, and 51% provided data through one year.
Results: Participants showed significant improvements in all cardiovascular risk factors considered (body mass index, resting heart rate, systolic blood pressure, diastolic blood pressure, cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and glucose) after both four weeks and one year. Loss to follow-up was highest among those who were ages 30–39, had a history of diabetes, had a history of being overweight, smoked, lived with a heavy smoker, were physically less active, or were experiencing stress. Those with higher BMI, SBP, DBP, or glucose at baseline were also more likely to be lost to follow-up through one year. Those who failed to improve their BMI, resting heart rate, serum cholesterol, HDL, LDL, triglycerides, or glucose after four weeks were 16%, 9%, 22%, 21%, 16%, 22%, and 15% more likely to be lost to follow-up, respectively.
Conclusions: The CHIP program improves cardiovascular disease risk factors through one year of follow-up. Poorer health status at baseline is associated with increased loss to follow-up. Failure to improve one or more cardiovascular risk factors after four weeks of intervention is predictive of loss to follow-up through one year.

Keywords: Aged, 80 and over, Cardiovascular Diseases - prevention & control, Follow-Up Studies, Health, Risk Factors, Risk Reduction Behavior

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750