Heart to Health: A Combined Lifestyle and Medication Intervention to Reduce Cardiovascular Disease (CVD) Risk

Cardiovascular disease (CVD), including heart disease and stroke, is the leading cause of
death in the US. Every year, more than one million Americans have a heart attack, and nearly
800,000 have a stroke. In 2010, heart disease alone is expected to cost the country more
than $316 billion in health care and lost productivity.

Both lifestyle changes and medication can reduce the risk of CVD, and this project combines
these approaches in the hopes of identifying a practical intervention for use in primary
care medical offices. The project combines two previously tested interventions and updates
them to meet current guidelines for diet and use of aspirin and cholesterol-controlling
drugs (statins).

The research team is delivering the combined intervention in two formats: web-based and
counselor-based. Each format has the same content, but the web-based advice is accessed
through the Internet by clients at home, a community site, or a primary care office. The
other format involves sessions delivered to clients by a counselor either in person at a
primary care office or over the telephone. The researchers will compare how effective each
format is in reducing participants' risk of coronary heart disease. They will also determine
the interventions' effect on participants' diet, physical activity, smoking status,
medication adherence, and other health indicators. In addition, the team will compare the
two formats' cost-effectiveness and how well the patients, office staff, and clinicians
accept the interventions.

Recruited from five family practices, 600 patients representing the geographic and ethnic
diversity of North Carolina are taking part in this study. Half the participants are
randomly assigned to the web-based intervention; the other half to the counselor-based
version. Both groups will also get information on local resources, such as gyms and farmers
markets, that can help participants maintain a healthy lifestyle.