Abstract
BackgroundAccording to the World Health Organization, cardiovascular diseases (CVDs) are the leading non-communicable cause of death. Awareness of the individual risk profile is crucial to implement a healthy lifestyle and prevent CVDs. Multiple studies demonstrated that atherosclerosis, the main cause of CVDs, begins early in life. Therefore, it may be necessary to start prevention programs already in childhood.MethodsThe EVA-Tyrol study is a population-based non-randomized controlled trial that will prospectively enroll 2000 participants from high schools and training companies in North- and East-Tyrol (Austria) and South-Tyrol (Italy). Participants will be assigned to either an intervention (n = 1500) or a control (n = 500) group. Intervention group participants will be enrolled at the 10th school grade (mean age 15–16 years), undergo two examinations within a two-year interval, with follow-up at the 12th grade (mean ages 17–18 years). Control group participants will be enrolled at the 12th grade (mean age 17–18 years). Medical examination will include anthropometric measurements, comprehensive lifestyle and dietary questionnaires, a fasting blood sample, high-resolution ultrasound of the carotid arteries, and measurement of carotid-femoral pulse wave velocity. Active intervention will consist of (1) enhancing knowledge about CVDs, (2) individual medical counseling based on the results of the baseline examination, (3) an online health promotion tool and (4) involvement of participants in planning and implementation of health promotion projects. Effectiveness of the intervention will be assessed by comparing the proportion subjects with ideal health metrics as defined by the American Heart Association between study groups.DiscussionThis study aims to improve cardiovascular health in Tyrolean adolescents by demonstrating the efficacy of a multi-layer health promotion program and may yield novel insights into the prevalence of vascular risk conditions and mechanisms of early vascular pathologies in adolescents.Trial registrationEVA-Tyrol has been retrospectively registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.
Highlights
According to the World Health Organization, cardiovascular diseases (CVDs) are the leading noncommunicable cause of death
According to the world health organization (WHO), 17.7 million people died from CVDs in 2015 [1, 2], with ischemic heart disease and stroke accounting for 26.6% of all deaths worldwide [3]
Our study explores novel grounds, as, even though numerous health promotion programs are targeted to the youth, few did prove efficacy
Summary
According to the World Health Organization, cardiovascular diseases (CVDs) are the leading noncommunicable cause of death. Awareness of the individual risk profile is crucial to implement a healthy lifestyle and prevent CVDs. Multiple studies demonstrated that atherosclerosis, the main cause of CVDs, begins early in life. Awareness of the individual risk profile and subsequent modification of risk factors and risk behavior are prerequisites for effective prevention. It is unclear at which age best to initiate prevention. Cohort studies have demonstrated the effects of risk factors on early atherosclerotic vessel wall thickening using high-resolution ultrasonography in children, adolescents and young adults [16, 17]. In Children, lifestyle and dietary counseling exhibits favorable effects on their cardiovascular risk profile without harmful side-effects [18, 21]
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