Abstract P162: Lifestyle Intervention Improves Global Cardiovascular Health in Latinos with Prediabetes in Maracaibo, Venezuela

Abstract

Introduction: The epidemics of obesity and hyperglycemia are associated with increased cardiovascular (CV) disease. There are limited data on the CV benefits of evidence-based lifestyle intervention strategies in developing countries. Aim: To assess impact o lifestyle intervention strategies based on the US Diabetes Prevention Program (DPP) on the global cardiovascular health. Methods: In a pilot clinical trial 140 Latino subjects (63.6% women) with prediabetes (ADA guidelines) were randomly assigned to receive either standard of care (SC, n=70) or group lifestyle (LS, n=70) intervention for 2 years in the healthcare system of Maracaibo, Venezuela. Ideal CV health behaviors (nonsmoking, achieving normal weight, enough physical activity, and a healthy diet) and ideal CV health factors (total cholesterol<200 mg/dl, blood pressure< 120/80 mmHg, and fasting blood glucose<100 mg/dl) were evaluated at baseline and every 6 months. We calculated the American Heart Association (AHA) global CV health score assigning 1 to each ideal behavior and factor (for a maximum of 7) and 0 for poor status to each one. Results: Subjects were aged 48.1±11.8 years, had a BMI of 32.1±5.5kg/m² and a baseline score CV of 3.9 ±0.1 (i.e., 84.3% in SC and 88.6% in LS had poor to intermediate CV score). Larger improvements in the CV scores from baseline were obtained in the LS vs. SC (p<0.0001) after 6 months (1.7±0.8 vs. 0.6±0.7), 12 months 2.3 ±0.8 vs. 1.2±0.8), 18 months (1.9±0.9 vs. 0.8±0.6) and 24 months (2.0±0.9 vs. 0.8±0.6) of intervention. At study end only 4.3% of LS and 47.1% of SC participants had poor-intermediate CV score (p<0.01). Conclusions: Implementation of DPP- based lifestyle intervention leads to moderate improvements in overall CV health among Latinos with prediabetes in Venezuela. Achievement of the proposed 2020 AHA goal for better CV health seems feasible in this high-risk Latino population.