Long-term effects of intensive intervention on changes in lifestyle in patients with hyperfibrinogenaemia and moderate-high cardiovascular risk

Objectives: To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk. Design: multicentre prospective observational study. Location: 13 Primary Care Centres in Barcelona and Baix Llobregat. Participants: A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group). Interventions: The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years. Main measurements: Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR. Results: At 5 years, the intervention group had a lower abdominal circumference (98 and 101 cm, respectively, P=.043), a lower weight (76.30 and 75.04 kg, respectively, P<.001), and BMI (29.5 and 30.97 kg/m(2), P=.018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P <.001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P<.06). Conclusion: The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS. (C) 2017 Published by Elsevier Espana, S.L.U.