Health and Wellness Coaching for 5-Year Projected Cardiovascular Health: A Randomized Controlled Trial

Area of Science:

• Cardiology
• Preventive Medicine
• Health Coaching

Background:

• Limited evidence exists for multifactorial lifestyle interventions in primary stroke prevention.
• Lifestyle significantly contributes to the overall stroke burden.
• Health and wellness coaching (HWC) is explored as a potential intervention.

Purpose of the Study:

• To determine the efficacy of HWC for primary stroke and cardiovascular disease (CVD) prevention.
• To assess HWC in adults at moderate-to-high CVD risk.
• To evaluate HWC's impact on 5-year CVD risk and Life's Simple 7 (LS7) scores.

Main Methods:

• Phase III, parallel, 2-arm, open-label, single-blinded randomized controlled trial.
• 320 participants (≥30 years) with 5-year CVD risk ≥10% were randomized to HWC or usual care (UC).
• Primary outcome: 5-year CVD risk at 9 months; secondary outcome: LS7 score.

Main Results:

• HWC achieved a statistically significant relative risk reduction (RRR) of -10.9% in 5-year CVD risk for the high-risk group (≥15% baseline risk).
• No significant change in CVD risk was observed in the moderate-risk group (10%-14%).
• The HWC group showed improved total LS7 scores (absolute difference = 0.485) and blood pressure scores compared to UC, particularly in the high-risk subgroup.

Conclusions:

• HWC demonstrated a clinically significant reduction in 5-year CVD risk for high-risk individuals.
• The study did not meet its primary hypothesis due to lack of effect in the moderate-risk group.
• HWC shows promise for refining lifestyle interventions to mitigate stroke risk factors.