Abstract MP092: Community-Based, Primary Prevention Programs Decrease the Rate of Metabolic Syndrome in Low Income and Minority Women
Background: Metabolic Syndrome (MetSyn), a composite of waist circumference, blood pressure, triglycerides, HDL and insulin sensitivity, is one of the strongest predictors of type 2 diabetes (DM) and cardiovascular disease (CVD). It is associated with a 4-10 fold increased risk of DM and a 2-3 fold increased risk of CVD. Low income and minority women have some of the highest rates of MetSyn. This study examines the effect of a community based, primary prevention program on the rates of MetSyn in this population.
Methods: 64 low income and minority women, with at least two preexisting risk factors, were enrolled in the HAPPY (Health Awareness and Primary Prevention in Your neighborhood) Heart Program in a suburb of Boston. Over this 2 year period, patients were evaluated by an interdisciplinary medical team: their primary physician, cardiologist, nutritionist, physical therapist and health coach. The rate of MetSyn was measured at baseline, year 1 and 2. Comparisons were made either using the paired t test for normally distributed variables or the Wilcoxon Sign test for non-normal variables.
Results: We examined the 5 components of the MetSyn individually and the overall MetSyn score (see table). The increase in HDL from baseline to year 1 was not significant, but by year 2, the average HDL had increased from 44.5 to 49.3 (p<0.001). Similarly, by year 2, we observed a decrease of 6.8 mmHg in systolic blood pressure (p=0.05). Finally, by year 2, the average decrease in HbA1c was 0.2 (p<0.001). From baseline to year 1, the average MetSyn score decreased by 0.33 (p=0.017) and by year 2, the improvements were sustained and improved, with an average reduction in score of 0.63 (p<0.001).
Conclusion: Our results demonstrate that a comprehensive, lifestyle intervention program is effective at decreasing MetSyn in a high risk minority female population. These improvements may take at least two years to become evident; however, when shepherded by a community based, interdisciplinary team, not only are the improvements significant, they are sustained.
- © 2012 by American Heart Association, Inc.