Effectiveness of a healthcare retreat for male employees with cardiovascular risk factors

Keiichi Matsuzaki,Takashi Kawamura,Kana Inoue,Shotaro Taniguchi

doi:10.1016/j.pmedr.2018.12.005

Keiichi Matsuzaki, Takashi Kawamura + Show 2 more

Open Access

https://doi.org/10.1016/j.pmedr.2018.12.005

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Abstract

Lifestyle modification is the primary treatment strategy for obesity, hypertension, dyslipidemia, and hyperglycemia. Recently, the Japanese government designed a healthcare retreat program for persons with cardiovascular risk factors. However, the structure and effectiveness of this program has not been fully discussed.Employees of a company group with obesity and one or more other cardiovascular risk factors were enrolled in the study. The participants in the three-day retreat program were compared with those receiving a brochure-based advice for their subsequent changes in the annual health check-up data using the propensity score matching method.Among the 415 eligible employees, 220 underwent the intensive program and 195 received a brochure-based advice. In the propensity score-matched subjects, reduction in body weight (2.7 kg vs. 0.99 kg, p < 0.01), waist circumference (3.5 cm vs. 1.5 cm, p < 0.01), and non-HDL cholesterol (8.8 mg/dl vs. 1.3 mg/dl, p = 0.05) were significantly greater in the intensive care group one year later. The superiority of the intensive program, however, was gradually attenuted for subsequent two years later.This healthcare retreat with counseling and training program would improve body weight and waist circumference for one to two subsequent years.

Highlights

Obesity, hypertension, dyslipidemia, and hyperglycemia are the well-known risk factors for cardiovascular diseases in economically advanced countries (Hunt et al, 2004; Malik et al, 2004), including Japan (Takeuchi et al, 2005)
Since 2008, the MHLW further forced health insurer to take the 6-month specified formula of health counseling performed by physicians, public health nurses, and registered dieticians for persons having obesity and two or more of either hypertension, dyslipidemia, glucose intolerance, or smoking
Blood tests were performed to analyze the concentration of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride (TG), fasting plasma glucose (FPG), and hemoglobin A1c (HbA1c) by the Japan Diabetes Society method

Summary

Introduction

Hypertension, dyslipidemia, and hyperglycemia are the well-known risk factors for cardiovascular diseases in economically advanced countries (Hunt et al, 2004; Malik et al, 2004), including Japan (Takeuchi et al, 2005). These preclinical pathologies often begin with accumulated visceral fat and subsequent insulin resistance derived from unhealthy lifestyles in addition to one's genetic predisposition. Since 2008, the MHLW further forced health insurer to take the 6-month specified formula of health counseling performed by physicians, public health nurses, and registered dieticians for persons having obesity and two or more of either hypertension, dyslipidemia, glucose intolerance, or smoking. The maintenance of weight loss has been poorly discussed and health professionals worry about the potential for short-term rebound in body weight and other risk factors

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