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Impact of a preventive cardiology clinic focusing on lifestyle and nutrition counseling: A pilot analysis.

ABSTRACT: Standard cardiology practice often defers preventive strategies to primary care providers. We aimed to evaluate the effectiveness of a preventive cardiology clinic focused on lifestyle and nutrition counseling combined with guideline-directed medical therapy on reducing cardiovascular disease (CVD) risk. We queried the University of Florida-Health database for patients enrolled in the preventive cardiology clinic, and a general and interventional cardiology clinic from January 2016 to October 2019. Mean change in weight and blood cholesterol including LDL cholesterol (LDL-C), total cholesterol (TC) and triglycerides (TG) were compared in the three clinics in the initial cohort and stratified into primary and secondary prevention. A propensity score-matched analysis was done to adjust for CVD risk factors and statin use. Among a cohort of 239 patients, enrollment in the preventive clinic (n = 99) was associated with greater weight loss at 6 months compared to other clinics (n = 140) (mean -1.7 vs +0.1 kg, p 0.007). Preventive clinic was also associated with greater mean reduction in LDL-C (-24.8 vs -7.1 mg/dl, p 0.021), TC (-29.3 vs -2.0, p 0.003) and TG (-19.7 vs +13.3, p 0.002) at both initial and last follow-up (median time 6 and 16 months). The association with reduction in TG was observed in both primary and secondary prevention, but reduction in LDL-C and TC was only significant in secondary prevention. In a propensity-matched linear regression analysis, preventive clinic was independently associated with LDL-C reduction (b -14.7, r -0.3, p 0.038). A preventive cardiology clinic focused on patient education can be effective in reducing CVD risk.

SUBMITTER: Elzeneini M

PROVIDER: S-EPMC10976304 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Impact of a preventive cardiology clinic focusing on lifestyle and nutrition counseling: A pilot analysis.

Elzeneini Mohammed M George Jerin J Ashraf Hassan H Xu Ke K Petersen John J Anderson R David RD Handberg Eileen M EM Pepine Carl J CJ Aggarwal Monica M

American heart journal plus : cardiology research and practice 20210601

Standard cardiology practice often defers preventive strategies to primary care providers. We aimed to evaluate the effectiveness of a preventive cardiology clinic focused on lifestyle and nutrition counseling combined with guideline-directed medical therapy on reducing cardiovascular disease (CVD) risk. We queried the University of Florida-Health database for patients enrolled in the preventive cardiology clinic, and a general and interventional cardiology clinic from January 2016 to October 20 ...[more]

PMID: 38560555

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Project description:ImportancePediatric obesity and hypertension are highly correlated. To mitigate both conditions, provision of counseling on nutrition, lifestyle, and weight to children with high blood pressure (BP) measurements is recommended.ObjectiveTo examine racial and ethnic disparities in receipt of nutrition, lifestyle, and weight counseling among patients with high BP at pediatric primary care visits stratified by patients' weight status.Design, setting, and participantsThis was a post hoc secondary analysis of the BP-CATCH study, a matched, stepped-wedge cluster randomized clinical trial investigating the best methods to screen children with high BP measurements and manage their care. Urban, suburban, and rural pediatric primary care practices across the US with a multidisciplinary team of at least 1 physician, 1 nurse and another practice associate, and a hypertension specialist for their practice group submitted baseline data from clinical encounters documented between November 2018 and January 2019. Practices identified the first 17 eligible patients with high BP measurements each month. This analysis was conducted from October 2023 to July 2024.ExposuresRace and ethnicity (Black, Hispanic, White, and other [Asian, multiracial, other races, and unknown race]) and weight status (with or without obesity).Main outcomes and measuresPrimary outcomes were receipt of counseling on nutrition, lifestyle, and weight during primary care visits. Baseline measures extracted from medical records included demographics, anthropometric measures, and systolic and diastolic BP.ResultsOf 2677 participants from 59 practices, 1516 (56.6%) were male; mean (SD) age was 10.8 (5.2) years. A total of 593 (21.1%) were Black; 414 (15.5%), Hispanic; 1111 (41.5%), White; and 559 (20.9%), other race and ethnicity. The overall crude unadjusted rates of receiving counseling were 63.5% (n = 1564 of 2463) for nutrition, 57.6% (n = 1419 of 2462) for lifestyle, 47.5% (n = 571 of 1202) for weight, and 46.4% (n = 1142 of 2461) for all counseling topics. Compared with the other 3 groups, Hispanic participants received significantly higher adjusted rates of nutrition (78.6%; 95% CI, 73.5%-83.8%), lifestyle (69.3%; 95% CI, 63.6%-74.9%), and all 3 (52.1%; 95% CI, 46.1%-58.2%) counseling topics. There were no significant differences in rates of receiving weight counseling between any pairs of groups. These findings were consistent in general among participants without obesity, and no significant pairwise differences were noted among participants with obesity except that nutrition counseling rates were significantly different between White participants and those reporting other race and ethnicity (68.3% [95% CI, 61.1%-75.4%] vs 81.6% [95% CI, 74.2%-89.1%]; Bonferroni-corrected P = .02).Conclusions and relevanceThis secondary analysis of the BP-CATCH trial found that among children with high BP measurements, racial and ethnic disparities in receiving nutrition, lifestyle, and all 3 counseling topics were significant, although no significant disparities in receipt of weight counseling were noted. Racial disparities in receipt of counseling were not observed in participants with and without obesity.Trial registrationClinicalTrials.gov Identifier: NCT03783650.

Dataset Information

Impact of a preventive cardiology clinic focusing on lifestyle and nutrition counseling: A pilot analysis.

Publications

Impact of a preventive cardiology clinic focusing on lifestyle and nutrition counseling: A pilot analysis.

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