Randomized controlled trial on the long-term efficacy of a multifaceted, interdisciplinary lifestyle intervention in reducing cardiovascular risk and improving lifestyle in patients at risk of cardiovascular disease.

The objective of the study was to evaluate the efficacy of an interdisciplinary intervention known as Educoeur in reducing cardiovascular risk and improving health behaviors in people without evidence of cardiovascular disease and to compare the Educoeur program to interventions in a specialized clinic and in usual care family practice. In a parallel, randomized, controlled trial of 185 adults with at least two modifiable cardiovascular risk factors, patients were randomly assigned to either Educoeur, specialized clinic or usual care. Cardiovascular risk, biological and lifestyle measures were assessed at baseline and at 2 years. In Educoeur, measurements were also taken before and after the lifestyle group treatment program. In 12 weeks, patients in Educoeur significantly lowered their cardiovascular risk, weight, body mass index, waist circumference, systolic blood pressure, kilocalories intake and improved their VO2 Max and mental health. Changes remained significant at 2 years. Between group comparisons at 2 years demonstrated that Educoeur was significantly better in reducing cardiovascular risk than interventions in usual care. Together, these results highlight the importance of providing interdisciplinary programs that optimize cardiovascular risk reduction and promote active lifestyles in patients at risk of cardiovascular disease.

Illness representation and change in dietary habits in hypercholesterolemic patients.

UNLABELLED: The association between a patient's illness representation and long-term changes in treatment adherence still needs to be clarified. AIM: to evaluate the association between the representation of hypercholesterolemia and dietary modifications over 1-year, controlling for biopsychosocial factors. METHODS: 208 hypercholesterolemic Caucasian patients. Measures of dietary intake, illness representation, and biopsychosocial factors were collected at baseline, 3, 6, and 12 months. RESULTS: Two multiple regressions were performed on the 1-year change in dietary habits; one with subjects with elevated fat consumption at baseline, another with individuals with low-moderate fat consumption. Higher scores on items reflecting an accurate illness representation at baseline were associated with greater dietary modification among patients of the first group. For patients with low-moderate total fat consumption, maintenance of dietary habits was associated to lower scores on the perception of stress and symptoms. CONCLUSION: To optimize adherence, intervention on illness representation should be adjusted according to initial dietary habits.