CLINICAL EFFECTIVENESS OF A COMMUNITY-BASED CARDIOVASCULAR RISK REDUCTION PROGRAM IN PARTICIPANTS WITH AND WITHOUT ARTHRITIS

Abstract

In the United States, arthritis is the leading cause of disability. By the year 2020, an estimated 60 million Americans will be affected by arthritis. Individuals with arthritis may engage in lower levels of physical activity and be at heightened risk for atherosclerotic cardiovascular disease (CVD). This study is the first, to our knowledge, to compare the clinical effectiveness of a community-based lifestyle management and CVD risk reduction program in participants with and without arthritis. Lifestyle management interventions included exercise training, correct nutrition, weight management, stress management, and smoking cessation. Participants were referred to their personal physicians for consideration of medication changes in accordance with national clinical guidelines. Subjects (n = 1,830) were evaluated at baseline and after approximately 1 year of participation in the program. Participants with self-reported arthritis (n = 357) were older (55.2 years versus 46.8 years) and more likely to have CVD and/or diabetes (31 percent versus 15.5 percent) as compared to participants without arthritis (n = 1,473). For participants with abnormal baseline CVD risk factors (based on national clinical guidelines), clinically relevant improvements were observed for multiple variables in both groups as follows (p < 0.05): systolic/diastolic BP (arthritis, −16/− 13 mmHg; no arthritis, −17/− 10 mmHg); total cholesterol (arthritis, −35 mg/dl; no arthritis, −28 mg/dl); LDL cholesterol (arthritis, −23 mg/dl; no arthritis, −14 mg/dl); HDL cholesterol (arthritis, 3 mg/dl; no arthritis, 6 mg/dl); triglycerides (arthritis, −48 mg/dl; no arthritis, −60 mg/dl); fasting glucose (arthritis, −43 mg/dl; no arthritis, −21 mg/dl), and weight (arthritis, −4.4 lbs; no arthritis, −3.3 lbs). With the exception of LDL cholesterol (greater reduction in participants with arthritis) and HDL cholesterol (greater increase in participants without arthritis), no statistically significant differences were observed for participants with arthritis as compared to participants without arthritis. These data demonstrate the similar clinical effectiveness of a community-based lifestyle management and CVD risk reduction program in participants with and without arthritis.