Effects of a comprehensive lifestyle intervention on cardiovascular health: the TANSNIP-PESA trial
Effects of a comprehensive lifestyle intervention on cardiovascular health: the TANSNIP-PESA trial
Aims
To investigate the effectiveness of a 3-year worksite lifestyle intervention on cardiovascular metrics and to study whether outcomes are influenced by baseline subclinical atherosclerosis (SA) by non-invasive imaging.
Methods and results
A randomized controlled trial was performed to compare a lifestyle intervention with standard of care in asymptomatic middle-aged subjects, stratified by SA. The intervention consisted of nine motivational interviews during the first year, followed by three further sessions between Years 1 and 3. The primary outcome was the change in a pre-specified adaptation of the Fuster-BEWAT score (Blood pressure, Exercise, Weight, Alimentation, and Tobacco) between baseline and follow-up Years 1-3. A total of 1020 participants (mean age 50 ± 4 years) were enrolled, of whom 510 were randomly assigned to the intervention and 510 to the control group. The baseline adapted Fuster-BEWAT score was 16.2 ± 3.7 points in the intervention group and 16.5 ± 3.5 points in the control group. At Year 1, the score improved significantly in intervention participants compared with controls [estimate 0.83 (95% CI 0.52-1.15) points]. However, intervention effectiveness decreased to non-significant levels at Year 3 [0.24 (95% CI -0.10 to 0.59) points]. Over the 3-year period, the intervention was effective in participants having low baseline SA [0.61 (95% CI 0.30-0.93) points] but not in those with high baseline SA [0.19 (95% CI -0.26 to 0.64) points].
Conclusion
In middle-aged asymptomatic adults, a lifestyle intervention was associated with a significant improvement in cardiovascular health and behavioural metrics. The effect attenuated after 1 year as the intensity of the intervention was reduced.
Keywords
Cardiovascular; Lifestyle intervention; Randomized controlled trial; Subclinical atherosclerosis.
References
About The Author
Femke van Nassau is a senior researcher at the Amsterdam UMC, VUmc, specializing in human movement science. Her work at the Department of Public and Occupational Health and the Amsterdam Public Health Research Institute focuses on developing, implementing, and scaling up lifestyle interventions to promote physical activity and reduce sedentary behavior. With a PhD in scaling up school-based obesity prevention programs, she continues to lead innovative health promotion projects across various settings.
