Preventive counselling with the use of remote technologies provides effective control of metabolic risk factors in patients with high and very high cardiovascular risk

Abstract

Purpose: to assess the impact of preventive counseling with focus on diet modification on lipid and metabolic parameters in patients with high/very high cardiovascular (CV) risk who visited Health centers. Materials and methods. This was a prospective randomized controlled study of patients aged 40 to 65 years with high/very high CV risk (≥5% according to the Systematic Coronary Risk Evaluation scale [SCORE]) and any 2 criteria for metabolic syndrome. Patients were 1:1 randomized into 2 groups. The intervention group (n=50) received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group (n=50) received usual care in Health centers which also included basic preventive counseling. Results. A total of 100 patients (women 82%, age 59.74±4.66 years) were randomized. At baseline 81% of patients had high and 19% - very high CV risk. The groups were well balanced according to demographic and clinical features. At 1 year of follow-up patients from the intervention group experienced significant improvement of metabolic parameters compared with controls: their diastolic blood pressure (BP) decreased by 5.62±7.7 mm Hg, total and low-density lipoprotein cholesterol (TC and LDL-C) - by 0.5±0.83 and 0.46±0.62 mmol/l, respectively. Both groups experienced statistically and clinically significant decreases in systolic BP (intervention, - 17.76±16.2 mm Hg, control, - 13.44±15.6 mm Hg; both groups p<0.001). Nevertheless, the difference between groups at 1 year was not significant. Also, patients from the intervention group vs controls experienced significant improvement of adiposity parameters: their weight decreased by 2.43 ± 2.74 kg, body mass index - by 0.9±0. 99 kg/m 2 , waist circumference - by 1.96±3.2 cm, and height-normalized body fat mass (according to bio-impedance) - by 1.63 ± 2.3%. Conclusion: Preventive counseling with focus on diet modification followed by 3 months remote support by phone provided significant improvement of metabolic and lipid parameters.