Reduced Cardiovascular Disease Incidence With a National Lifestyle Change Program

Introduction Lifestyle change programs implemented within healthcare systems could reach many Americans, but their impact on cardiovascular disease (CVD) remains unclear. The MOVE! program is the largest lifestyle change program implemented in a healthcare setting in the U.S. This study aimed to det...

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Bibliographic Details
Published in:American journal of preventive medicine 2017-04, Vol.52 (4), p.459-468
Main Authors: Jackson, Sandra L., PhD, Safo, Sandra, PhD, Staimez, Lisa R., PhD, Long, Qi, PhD, Rhee, Mary K., MD, Cunningham, Solveig A., PhD, Olson, Darin E., MD, Tomolo, Anne M., MD, Ramakrishnan, Usha, PhD, Narayan, K.M. Venkat, MD, Phillips, Lawrence S., MD
Format: Article
Language:English
Subjects:
Adult
Body mass index
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cerebrovascular disease
Clinical outcomes
Cohort analysis
Coronary artery disease
Diabetes
Disease prevention
Ethnicity
Exercise
Female
Health care industry
Heart failure
Humans
Hypertension
Incidence
Internal Medicine
Life Style
Lifestyles
Male
Middle Aged
Military hospitals
Obesity
Participation
Preventive medicine
Race
Retrospective Studies
Risk factors
Smoking
United States - epidemiology
United States Department of Veterans Affairs
Vascular disease
Veterans
Veterans Health
Weight Reduction Programs - statistics & numerical data
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Summary:Introduction Lifestyle change programs implemented within healthcare systems could reach many Americans, but their impact on cardiovascular disease (CVD) remains unclear. The MOVE! program is the largest lifestyle change program implemented in a healthcare setting in the U.S. This study aimed to determine whether MOVE! participation was associated with reduced CVD incidence. Methods This retrospective cohort study, analyzed in 2013–2015, used national Veterans Health Administration databases to identify MOVE! participants and eligible non-participants for comparison (2005–2012). Patients eligible for MOVE!—obese or overweight with a weight-related health condition, and no baseline CVD—were examined (N=1,463,003). Of these, 169,248 (12%) were MOVE! participants. Patients were 92% male, 76% white, with mean age 52 years and BMI of 32. The main outcome was incidence of CVD (ICD-9 and procedure codes for coronary artery disease, cerebrovascular disease, peripheral vascular disease, and heart failure). Results Adjusting for age, race, sex, BMI, statin use, and baseline comorbidities, over a mean 4.9 years of follow-up, MOVE! participation was associated with lower incidence of total CVD (hazard ratio [HR]=0.83, 95% CI=0.80, 0.86); coronary artery disease (HR=0.81, 95% CI=0.77, 0.86); cerebrovascular disease (HR=0.87, 95% CI=0.82, 0.92); peripheral vascular disease (HR=0.89, 95% CI=0.83, 0.94); and heart failure (HR=0.78, 95% CI=0.74, 0.83). The association between MOVE! participation and CVD incidence remained significant when examined across categories of race/ethnicity, BMI, diabetes, hypertension, smoking status, and statin use. Conclusions Although participation was limited, MOVE! was associated with reduced CVD incidence in a nationwide healthcare setting.
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2016.10.013