P5138Improvement in cardiovascular risk scores by a diet and exercise programme for obese and overweighted young adults

Abstract

Obesity and overweight increase cardiovascular risk. Diet and exercise have a beneficial effect, but its relative weight and its early influence on improving Coronary Risk Scores are still discussed. Methods: 511 overweighted or obese bank clerks from a Prevention Service were enrolled in a 6 months health programme, consisting of personalized diet and reinforcement by a Dietitian, and monitorized exercise program, together with antihypertensive or lipids treatment when necessary. Basal echocardiogram and ergometry were performed. Blood pressure, heart rate, anthropometric values, blood biochemistry and cardiovascular risk scores (SCORE, Framingham, and Framingham derived REGICOR (validated in Spanish population) an DORICA (validated in obese patients) were statistically compared before and after completing the follow-up. Results: 192 (37.57%) completed the programme. Mean age was 44.6 y.o.,74.5% were male, and mean Body mass index (BMI) was 32.46 (27-52.6). Obesity and sedentarism were present in 68.8% and 57.8%. respectively. 13.5% were smokers,28.6% showed dyslipidemia, and 14.6% hypertension (78.57% treated, and 3.6% were new diagnoses, 42.86% beginning pharmacological treatment). A BMI percentage loss of 10.1% (-1.33-24.32%) (p<0.0001) was achieved after 6 months, improving metabolic parameters (LDLc 136.4 vs 120.4, HDLc 44.4 vs 50, Triglycerides 120.2 vs 89.4, Glycaemia 95.4 vs 88.1 mg/dl), and blood pressure (129/81 vs 126/76 mmHg), with a reduction of REGICOR from 2.99% to 2.21%, DORICA from 5.54% to 3.85% and Framingham from 7.17% to 5.3% (p<0.0001 for all comparisons), and no reduction in SCORE (0.41 vs 0.40; p=0.565). By regression analysis, after adjustment by age, blood pressure reduction and treatment, Total and HDL cholesterol differences, and smoking, we found that increase in weekly hours of exercise (2.3 vs. 4.3 h/w), and not BMI percentage loss, significantly explained the reduction in cardiovascular risk scores. Conclusions: A 6 month health program based on diet and exercise in obese and overweighted people improved weight and metabolic profile. Even in a young, low risk population, coronary risk scores (but not SCORE, implying hard events as cardiovascular death) improved, due mainly to exercise, blood pressure and metabolic improvement, and not directly to weight loss. Abandonment rate was high.