In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to EAPC Ivory (& above) Members, Fellows of the ESC and Young combined Members

Effects of a community-based lifestyle intervention in older patients with coronary artery disease: results from the RESPONSE-2 trial

Session Poster Session 2

Speaker Patricia Jepma

Congress : EuroPrevent 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P522

Authors : P Jepma (Amsterdam,NL), HT Jorstad (Amsterdam,NL), RJG Peters (Amsterdam,NL), MS Snaterse (Amsterdam,NL), G Ter Riet (Amsterdam,NL), CHM Latour (Amsterdam,NL), M Minneboo (Amsterdam,NL), SM Boekholdt (Amsterdam,NL), WJM Scholte Op Reimer (Amsterdam,NL)

Authors:
P Jepma1 , HT Jorstad2 , RJG Peters2 , MS Snaterse1 , G Ter Riet3 , CHM Latour1 , M Minneboo2 , SM Boekholdt2 , WJM Scholte Op Reimer1 , 1Amsterdam University of Applied Sciences, ACHIEVE Centre for Applied Research, Faculty of Health - Amsterdam - Netherlands (The) , 2Amsterdam UMC, Department of Cardiology - Amsterdam - Netherlands (The) , 3Amsterdam UMC, Department of General Practice - Amsterdam - Netherlands (The) ,

On behalf: the RESPONSE2 group

Citation:

Background/Introduction: Interventions to reduce lifestyle-related risk factors (LRFs) such as overweight, physical inactivity and smoking are effective in the secondary prevention of cardiovascular events. However, evidence of the effects of lifestyle-related secondary prevention programmes in older patients is less conclusive than in younger patients.

Purpose: Using data of the RESPONSE-2 trial, we compared the treatment effect on LRFs in younger (< 65 years) patients to the effect in older (= 65 years) patients with coronary artery disease (CAD).

Methods: The RESPONSE-2 trial was a community-based lifestyle intervention trial (N=824) comparing nurse-coordinated referral to a comprehensive set of three lifestyle interventions (physical activity, weight reduction and/or smoking cessation) to care as usual. In the current analysis, our primary outcome was the proportion of patients with improvement at 12 months follow-up (N=711) in at least 1 LFR (without deterioration in the other LFRs) stratified by age.

Results: At baseline, patients = 65 years (n=145, mean age 69.2 ± 3.9) had significantly more risk factors and comorbidities (hypertension, diabetes mellitus and peripheral artery disease) compared with patients < 65 years (n=579, mean age 53.7 ± 3.9). At follow-up, the proportion of older patients with improvement in = 1 LFR was 41.4% (41/99) in the intervention group compared with 25.8% (31/120) patients in the control group (RR 1.60, 95% CI 1.09 - 2.35). The proportion of younger patients with improvement in = 1 LFR was 35.2% (92/261) in the intervention group compared with 26.0% (60/231) in the control group (RR 1.36, 95% CI 1.03 - 1.78) (figure). In the intervention group, older patients with baseline BMI = 27kg/m2 were more successful in achieving weight reduction (= 5%) compared with younger patients with baseline BMI = 27kg/m2  (52.8% vs. 25.4%, p <0.001).

Conclusion: Despite the presence of more risk factors and comorbidities, nurse-coordinated referral to a community-based lifestyle intervention appears to be at least as successful in improving lifestyle in older as in younger patients. Age alone should not be a reason to withhold comparable preventive initiatives in older adults with CAD.



Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are