Four-year follow-up of the Choice of Health Options In prevention of Cardiovascular Events randomized controlled trial

Neubeck, Lis; Freedman, SB; Briffa, Tom; Bauman, Adrian; Redfern, Julie

Abstract

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 (n¼72) or CHOICE (n¼72) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support. A contemporary CR reference group were also recruited (n¼64). 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 4.00.1 vs. 4.20.1 mmol/l, P¼0.05), significantly better systolic blood pressure (mean 132.22.1 vs. 136.82.0 mmHg, P¼0.01), physical activity scores (1200209 vs. 968196 metabolic
equivalent min/week, P¼0.02) and proportion with three or more risk factors above national targets (20 vs. 42%, P¼0.02). 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.

• Journal Article Type: Article
• Acceptance Date: May 31, 2010
• Online Publication Date: Jan 28, 2011
• Publication Date: Apr 1, 2011
• Deposit Date: Nov 3, 2016
• Journal: European Journal of Cardiovascular Prevention & Rehabilitation
• Print ISSN: 1741-8267
• Electronic ISSN: 1741-8275
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 2
• Pages: 278-286
• DOI: https://doi.org/10.1097/hjr.0b013e32833cca66
• Keywords: Acute coronary syndrome, cardiovascular risk reduction, long-term follow-up, secondary prevention,
• Public URL: http://researchrepository.napier.ac.uk/Output/411890