To evaluate the effectiveness of a cardiovascular disease prevention program in the control of cardiovascular risk factors in a low-income population from the Caribbean region of Colombia
A retrospective cohort study was conducted. A population of 128,265 patients enrolled in the “De todo corazón” program between 2013-2018 with hypertension (HTA), diabetes mellitus (DM2), dyslipidemia or chronic kidney disease (CKD) was considered for eligibility. A paired analysis was conducted by selecting patients enrolled in 2016 with at least one year of follow-up. Baseline and follow-up scenarios were constructed by selecting the last measurement of clinical variables in a 3-month period after the date of enrollment and the last measurement available in the study period. Patients with blood pressure (BP) <140/90, low-density lipoprotein cholesterol (LDL) <=100mg/dl) and glycated hemoglobin (hba1c) <=7.5% were considered as controlled. Paired t-test and McNemmar test were used to compare clinical values and proportion of patients controlled in both scenarios. Paired mean differences and Cohen´s D statistic were used as absolute and relative measures of effect size. A p value <0.050 was considered significant
A sample of 17,713 (13.8%) patients was obtained. 65.0% were women, had a mean(SD) age of 59.5(13.0) and 61.8 (13.0) years at baseline and follow-up. Prevalence of HTA, DM2, dyslipidemia and CKD were 94.4%, 30.6%, 58.2% and 17.6%, respectively. No change in prevalences was observed. At follow up, an increase in proportion of patients with frequent physical activity (n=10,723: +28.1%), controlled BP (n=16,691: +28.6%) and controlled LDL (n=9,139; +33.0%) was observed (p<0.001). Systolic BP, diastolic BP and LDL reduced in their mean values (mean difference, Cohen´s D) (-3.0mmHg;0.15), (-4.1 mmHg;0.25) and (-10.0 md/dL; 0.19), respectively (p<0.001). No significant change was observed in hba1c (p=0.229)
The DTC program is effective in the promotion of physical activity and control of BP and LDL
© 2020 Published by Elsevier Inc.