Abstract P365: Effects of a Health Partner Intervention on Arterial Health

• Published in: Circulation (New York, N.Y.) Vol. 135; no. suppl_1
• Main Authors: Mohamed Kelli, Heval, Heinl, Robert, Hajjari, Jamal, Noreen, Samantha, Ko, Yi-An, Hammadah, Muhammad, Samman-Tahhan, Ayman, Sandesara, Pratik, Alghamdi, Talal, Chivukula, Kaavya, Corrigan, Frank, Al Mheid, Ibhar, Ziegler, Thomas, Gibson, Greg, Lampl, Michelle, Brigham, Kenneth, Vaccarino, Viola, Martin, Greg, Quyyumi, Arshed A
• Format: Journal Article
• Language: English
• Published: 07.03.2017
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.135.suppl_1.p365

Abstract only Introduction: Lifestyle modification is effective for cardiovascular disease prevention. Whether lifestyle intervention also preserves vascular health is less clear. Our study examined the role of a Health Partner-administered lifestyle intervention on vascular function. Hypothesis: Lifestyle intervention improves and preserves vascular function. Methods: A total of 711 university employees (48±11 years, 66% women, 22.5% Black) enrolled in a program that promoted healthier lifestyles at Emory University. Participants collaborated with a Health Partner to generate a personalized plan focused on achieving ideal health metrics. Anthropometric, laboratory and vascular function measurements were performed at baseline and at 1-year and 2-years of follow-up. Arterial stiffness was assessed by carotid-femoral pulse wave velocity and radial tonometry-derived central augmentation index. Microvascular function was assessed as digital reactive hyperemia index. Flow-mediated dilation was measured using ultrasound. The sample was divided into individuals within the lowest tertile and those in the upper two tertiles for vascular function at baseline. Paired t-test was used to assess the changes in vascular functions at 1 and 2 years of follow-up compared to baseline. Results: At each of the 1-year and 2-year follow-up visits, vascular function improved in the group within the abnormal tertile at baseline. Flow-mediated dilation increased by 1.6% and 2.0% (P<0.001) respectively, pulse wave velocity decreased by 0.85 m/s and 0.93 m/s (P<0.001), central augmentation index was lower by 3.4 and 3.2 (P<0.001), and microvascular function assessed by reactive hyperemia index improved by 0.48 and 0.52 (P<0.001). In those within the upper two tertiles, pulse wave velocity did not significantly change, but flow-mediated dilation and reactive hyperemia index showed significant decline at 2 years of follow up. Conclusion: A personalized, goal directed Health Partner intervention was associated with better vascular stiffness, endothelial and microvascular function in those with baseline abnormal values. These effects were evident at 1 year following enrollment and were sustained for 2 years. Whether the impact of Health Partner intervention on vascular function improves long-term morbidity and mortality needs further investigation in a controlled design.