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Coronary risk factor intervention: characteristics associated with change
Insights
Group sessions in the Multiple Risk Factor Intervention Trial helped reduce coronary heart disease risk factors. Attending sessions significantly increased smoking cessation and decreased cholesterol, while internal locus of control lowered blood pressure.
Area of Science:
- Cardiovascular Health
- Behavioral Medicine
- Public Health Interventions
Background:
- Coronary heart disease (CHD) poses a significant public health challenge.
- Identifying effective interventions for multiple CHD risk factors is crucial.
- The Multiple Risk Factor Intervention Trial (MRFIT) aimed to reduce CHD mortality through risk factor modification.
Purpose of the Study:
- To predict changes in key CHD risk factors (smoking, hypertension, cholesterol) within the MRFIT intervention group.
- To examine the influence of psychosocial factors, intervention engagement, and weight change on risk factor modification.
- To understand predictors of risk factor reduction in high-risk men.
Main Methods:
- Analysis of 652 high-risk men randomized into the MRFIT intervention group.
- Stratification based on baseline smoking status and hypertension medication use.
- Assessment of psychosocial characteristics, group session attendance, and weight change as predictors.
Main Results:
- No single model explained changes across all three risk factors.
- Group session attendance significantly increased smoking cessation (p ≤ .001).
- Internal locus of control predicted lower blood pressure, independent of medication (p ≤ .05).
- Attending group sessions was associated with decreased serum cholesterol when it was the primary concern (p ≤ .05).
Conclusions:
- Intervention strategies, particularly group sessions, can effectively target specific CHD risk factors.
- Psychosocial factors like locus of control play a role in managing hypertension.
- Tailored approaches are necessary as no single intervention model addresses all risk factors uniformly.
Abstract:
Predicting change in coronary heart disease (CHD) risk factors (cigarette smoking, hypertension, and cholesterol) was undertaken in participants randomized to the treatment group of the Harvard Center of the Multiple Risk Factor Intervention Trial. The predictor variables of interest were psychosocial characteristics, responses to the initial group sessions intervention strategy, and change in weight. The Harvard sample consists of 652 men identified at high risk of death from CHD. Fifty percent were randomized into an intervention group, and 50% were referred to their usual source of medical care. For the analyses, men were stratified by their baseline smoking status and whether they were taking medication for hypertension. The analyses revealed that there was no single model that explained changes in all three risk factors. For example, cigarette smokers were significantly more likely to stop smoking if they attended the group sessions (p less than or equal to .001). An internal locus of control predicted a lower blood pressure by the end of the first year independent of medication (p less than or equal to .05). If a participant entered the trial with serum cholesterol as the only risk factor of concern, attending the group sessions was associated with a significant decrease by the end of the first year (p less than or equal to .05).