Cardiovascular risk reduction and factors influencing loss to follow-up in the coronary health improvement project.

Background: This study determined whether the Coronary Health Improvement Project (CHIP) can improve cardiovascular disease risk factors through one year of follow-up and identified factors influencing loss to follow-up.

Material/methods: The CHIP program, an intensive four week community-based health education intervention designed to improve coronary risk factors, was evaluated using a quasi-experimental design. Analyses were based on 1,712 community volunteers, ages 30 to 87 from the Rockford, Illinois Metropolitan area. Of the participants, 97.7% completed the lifestyle evaluation at both baseline and after four weeks, and 51% provided data through one year.

Results: Participants showed significant improvements in all cardiovascular risk factors considered (body mass index, resting heart rate, systolic blood pressure, diastolic blood pressure, cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and glucose) after both four weeks and one year. Loss to follow-up was highest among those who were ages 30-39, had a history of diabetes, had a history of being overweight, smoked, lived with a heavy smoker, were physically less active, or were experiencing stress. Those with higher BMI, SBP, DBP, or glucose at baseline were also more likely to be lost to follow-up through one year. Those who failed to improve their BMI, resting heart rate, serum cholesterol, HDL, LDL, triglycerides, or glucose after four weeks were 16%, 9%, 22%, 21%, 16%, 22%, and 15% more likely to be lost to follow-up, respectively.

Conclusions: The CHIP program improves cardiovascular disease risk factors through one year of follow-up. Poorer health status at baseline is associated with increased loss to follow-up. Failure to improve one or more cardiovascular risk factors after four weeks of intervention is predictive of loss to follow-up through one year.