OBJECTIVE: To determine if the improved risk factor profile at 1 year attributed to the Choice of Health Options In prevention of Cardiovascular Events (CHOICE) program was maintained at 4 years. DESIGN: Single-blind randomized controlled trial with post-hoc 476 months follow-up (76% complete). SETTING: Australian tertiary referral hospital. PATIENTS: Two hundred and eight acute coronary syndrome survivors. INTERVENTIONS: Acute coronary syndrome survivors not accessing cardiac rehabilitation (CR) were randomized to control (n=72) or CHOICE (n=72) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support. A contemporary CR reference group were also recruited (n=64). Blinded risk assessment occurred at baseline, 1 and 4 years. MAIN OUTCOME MEASURES: Total cholesterol, systolic blood pressure, smoking status, physical activity. RESULTS: One year improvements in all the modifiable risk factors achieved in CHOICE were maintained at 4 years. CHOICE and control were well-matched at baseline. At 4 years, there was a trend towards lower total cholesterol in CHOICE compared with controls (mean 4.0+/-0.1 vs. 4.2+/-0.1 mmol/l, P=0.05), significantly better systolic blood pressure (mean 132.2+/-2.1 vs. 136.8+/-2.0 mmHg, P=0.01), physical activity scores (1200+/-209 vs. 968+/-196 metabolic equivalent min/week, P=0.02) and proportion with three or more risk factors above national targets (20 vs. 42%,P=0.02). Participants in CHOICE were at higher baseline risk than CR but at 4 years they had similar risk factor profiles. CONCLUSION: Participants in CHOICE maintained favorable changes in coronary risk profile at 4 years compared with control, indicating that CHOICE is an effective long-term intervention among those not accessing facility-based CR.
AD - Faculty of Medicine, University of Sydney, Sydney, Australia. lneubeck@med.usyd.edu.au AN - 20606594 BT - European Journal of Cardiovascular Prevention and Rehabilitation DA - 78036400918 ET - 2010/07/08 LA - eng M1 - 2 N1 - Neubeck, LisFreedman, S BBriffa, TomBauman, AdrianRedfern, JulieResearch Support, Non-U.S. Gov'tEnglandEuropean journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise PhysiologyEur J Cardiovasc Prev Rehabil. 2011 Apr;18(2):278-86. N2 -OBJECTIVE: To determine if the improved risk factor profile at 1 year attributed to the Choice of Health Options In prevention of Cardiovascular Events (CHOICE) program was maintained at 4 years. DESIGN: Single-blind randomized controlled trial with post-hoc 476 months follow-up (76% complete). SETTING: Australian tertiary referral hospital. PATIENTS: Two hundred and eight acute coronary syndrome survivors. INTERVENTIONS: Acute coronary syndrome survivors not accessing cardiac rehabilitation (CR) were randomized to control (n=72) or CHOICE (n=72) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support. A contemporary CR reference group were also recruited (n=64). Blinded risk assessment occurred at baseline, 1 and 4 years. MAIN OUTCOME MEASURES: Total cholesterol, systolic blood pressure, smoking status, physical activity. RESULTS: One year improvements in all the modifiable risk factors achieved in CHOICE were maintained at 4 years. CHOICE and control were well-matched at baseline. At 4 years, there was a trend towards lower total cholesterol in CHOICE compared with controls (mean 4.0+/-0.1 vs. 4.2+/-0.1 mmol/l, P=0.05), significantly better systolic blood pressure (mean 132.2+/-2.1 vs. 136.8+/-2.0 mmHg, P=0.01), physical activity scores (1200+/-209 vs. 968+/-196 metabolic equivalent min/week, P=0.02) and proportion with three or more risk factors above national targets (20 vs. 42%,P=0.02). Participants in CHOICE were at higher baseline risk than CR but at 4 years they had similar risk factor profiles. CONCLUSION: Participants in CHOICE maintained favorable changes in coronary risk profile at 4 years compared with control, indicating that CHOICE is an effective long-term intervention among those not accessing facility-based CR.
PY - 2011 SN - 1741-8275 (Electronic)1741-8267 (Linking) SP - 278 EP - 86 T2 - European Journal of Cardiovascular Prevention and Rehabilitation TI - Four-year follow-up of the Choice of Health Options In prevention of Cardiovascular Events randomized controlled trial VL - 18 ER -