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Garcia-Lunar I, van der Ploeg HP, Fernández Alvira JM, van Nassau F, Castellano Vázquez JM, van der Beek AJ, Rossello X, Fernández-Ortiz A, Coffeng J, van Dongen JM, Mendiguren JM, Ibáñez B, van Mechelen W, Fuster V. Effects of a comprehensive lifestyle intervention on cardiovascular health: the TANSNIP-PESA trial. Eur Heart J 2022; 43:3732-3745. [PMID: 35869885 PMCID: PMC9553098 DOI: 10.1093/eurheartj/ehac378] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/29/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Aims To investigate the effectiveness of a 3-year worksite lifestyle intervention on cardiovascular metrics and to study whether outcomes are influenced by baseline subclinical atherosclerosis (SA) by non-invasive imaging. Methods and results A randomized controlled trial was performed to compare a lifestyle intervention with standard of care in asymptomatic middle-aged subjects, stratified by SA. The intervention consisted of nine motivational interviews during the first year, followed by three further sessions between Years 1 and 3. The primary outcome was the change in a pre-specified adaptation of the Fuster-BEWAT score (Blood pressure, Exercise, Weight, Alimentation, and Tobacco) between baseline and follow-up Years 1–3. A total of 1020 participants (mean age 50 ± 4 years) were enrolled, of whom 510 were randomly assigned to the intervention and 510 to the control group. The baseline adapted Fuster-BEWAT score was 16.2 ± 3.7 points in the intervention group and 16.5 ± 3.5 points in the control group. At Year 1, the score improved significantly in intervention participants compared with controls [estimate 0.83 (95% CI 0.52–1.15) points]. However, intervention effectiveness decreased to non-significant levels at Year 3 [0.24 (95% CI –0.10 to 0.59) points]. Over the 3-year period, the intervention was effective in participants having low baseline SA [0.61 (95% CI 0.30–0.93) points] but not in those with high baseline SA [0.19 (95% CI –0.26 to 0.64) points]. Conclusion In middle-aged asymptomatic adults, a lifestyle intervention was associated with a significant improvement in cardiovascular health and behavioural metrics. The effect attenuated after 1 year as the intensity of the intervention was reduced. Trial registration ClinicalTrials.gov (NCT02561065).
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Affiliation(s)
- Ines Garcia-Lunar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, University Hospital La Moraleja , Madrid , Spain
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | | | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Jose Maria Castellano Vázquez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Monteprincipe, Grupo HM Hospitales , Madrid , Spain
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases , Palma , Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC , Madrid , Spain
| | - Jennifer Coffeng
- Dutch Institute of Employee Benefits Schemes (UWV) , Amsterdam , The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands
| | | | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, IIS-Hospital Universitario Fundación Jiménez Díaz , Madrid , Spain
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- Cardiovascular Institute, Mount Sinai Heart at Icahn School of Medicine , New York, NY , USA
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Dominguez Rodriguez F, Fernandez Alvira JM, Fernandez Friera L, Lopez-Melgar B, Blanco-Rojo R, Fernandez-Ortiz A, Garcia-Pavia P, Sanz JM, Mendiguren JM, Ibanez B, Bueno H, Fuster V, Lara-Pezzi E, Ordovas JM. P2466Association of actigraphy-measured sleep parameters and subclinical atherosclerotic burden: the PESA study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Dominguez Rodriguez
- University Hospital Puerta de Hierro Majadahonda, National Centre for Cardiovascular Research (CNIC). CIBERCV, Madrid, Spain
| | | | - L Fernandez Friera
- National Centre for Cardiovascular Research (CNIC), CIBERCV.HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM-CIEC, Madrid, Spain, Madrid, Spain
| | - B Lopez-Melgar
- National Centre for Cardiovascular Research (CNIC), HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM-CIEC, Madrid, Spain, Madrid, Spain
| | | | - A Fernandez-Ortiz
- National Centre for Cardiovascular Research (CNIC), CIBERCV. Universidad Complutense.Cardiovascular Institute, IDSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - P Garcia-Pavia
- University Hospital Puerta de Hierro Majadahonda, CIBERCV. Faculty of Health Sciences, University Francisco de Vitoria (UFV), Madrid, Spain
| | - J M Sanz
- Mount Sinai School of Medicine, Zena and Michael A. Wiener Cardiovascular Institute. CNIC (Madrid), New York, United States of America
| | | | - B Ibanez
- National Centre for Cardiovascular Research (CNIC), CIBERCV, IIS-Fundaciόn Jiménez Díaz Hospital, Madrid, Spain
| | - H Bueno
- National Centre for Cardiovascular Research (CNIC), Cardiology Department, Hospital Universitario 12 de Octubre.Universidad Complutense de Madrid, Madrid, Spain
| | - V Fuster
- National Centre for Cardiovascular Research (CNIC), Zena and Michael A. Wiener Cardiovascular Institute. Icahn School of Medicine Mount Sinai, New York, Madrid, Spain
| | - E Lara-Pezzi
- National Centre for Cardiovascular Research (CNIC), CIBERCV, Madrid, Spain
| | - J M Ordovas
- National Centre for Cardiovascular Research (CNIC), IMDEA Food Institute, CEI UAM + CSIC,U.S. Dept of Agriculture HNRCA. Tufts University, Boston, US, Madrid, Spain
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