Effects of health intervention program on cardiometabolic risk profiles from health evaluation center in Asian population: a longitudinal study and propensity analysis.
BACKGROUND
Health intervention program (HIP) based on diet and lifestyle modifications had been shown to improve cardiovascular risks. The effects of such program on a variety of cardiometabolic outcome measures conducted in a strict analysis remained relatively unexplored.


METHODS
A total of 2,660 participants (mean age: 43.3 ± 10 years, 63.6% male) underwent annual health survey from our health evaluation department. We implemented health intervention program (HIP) in which diet and lifestyle modifications including smoking cessation and advised physical activities were introduced. We further studied the effects of HIP on several cardiometabolic outcome measures including Framingham, metabolic scores and renal function in terms of Egfr with a mean follow-up period of 38.5 months. Propensity score (PS) matching (HIP vs non-HIP group) was used to avoid effects of case selection bias.


RESULTS
Totally 1,004 (502 subjects for each group) left after PS matching protocol (both HIP and non-HIP group). The HIP group showed significant decline of waist circumference (-1.46 ± 0.61, p = 0.016), post-prandial glucose (-6.77 ± 2.06, p = 0.001), and total cholesterol level (-4.42 ± 2.15, p = 0.04), with borderline increase in eGFR (1.72 ± 0.94, p = 0.068) after an average of 1.91 ± 1.14 year follow up period. Exercise behavior significantly increased for those who received HIP when compared to the non-HIP group (44.6 vs 52.4 %, p = 0.014). PS matching and difference-in-difference (DID) analysis further confirmed the beneficial effects of ATP III reduction by HIP (-0.36 ± 0.06, p < 0.05).


CONCLUSIONS
We demonstrated in our study that several cardiometabolic profiles can be substantially improved after health intervention introduction at the health evaluation center, supporting the beneficial evidence of such health intervention programs implementation based on primary prevention view points.
The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. carrie@ms1.mmh.org.tw.|Health Evaluation Center, Mackay Memorial Hospital, Taipei, Taiwan. carrie@ms1.mmh.org.tw.
Chuan-Chuan
CC
Liu
The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Chung-Lieh
CL
Hung
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Shou-Chuan
SC
Shih
Health Evaluation Center, Mackay Memorial Hospital, Taipei, Taiwan.
Hung-Ju
HJ
Ko
The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. rchang@ntu.edu.tw.
Ray-E
RE
Chang
D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003376:Counseling / Q000706:statistics & numerical data*; D004032:Diet; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012306:Risk