Background and Aims: Family history of coronary artery disease (CAD) is associated with a 1.5- to 2-fold increase in cardiovascular risk among first-degree relatives (parents, siblings, and children). Spouses of patients with CAD have also been shown to be at increased cardiovascular risk. Targeted screening and prevention strategies aimed at controlling modifiable risk factors may be appropriate for these populations The aim of the present study was to assess the degree to which medical treatment and lifestyle changes are initiated following coronary risk factor screening and brief counseling among family members (siblings, offspring, and spouses) of patients recently hospitalized with CAD.
Methods: A pretest, posttest pilot study was conducted at the University of Ottawa Heart Institute. One hundred and twenty family members of patients attending the Institute's cardiac rehabilitation program were screened for cardiovascular risk factors (smoking status, body weight, waist circumference, blood pressure, blood lipids, blood glucose, physical activity and dietary habits, and perceived stress) as well as current medication use. They then received a 1-hour counseling session to identify goals, strategies, and resources that could reduce cardiovascular risk. Participants were advised to see their family doctor if measured risk factors exceeded critical levels. Participants were contacted by telephone 3 months after the screening and counseling session and medical treatment and lifestyle changes initiated as a result of the intervention were assessed. Descriptive statistics were calculated and paired t test analyses were performed.
Results: Participants had a mean age of 51.1 years and were predominantly female (67.9%), and 69.8% of participants showed to have a moderate 10-year Framingham risk. At 3-month follow-up, 34.2% of participants reported that they had seen their family physician, 8.3% had undergone further testing, and 5.2% of smokers had quit smoking. Participants also reported losing an average of 6.7 kg (paired t test P = .00), and consuming more servings of vegetables each day (P < .05). There were no apparent changes in physical activity, waist circumference, or servings of fruit each day. 2.5% of participants indicated that they had visited an emergency department during the follow-up period.
Conclusions: Coronary risk factor screening and brief counseling were associated with initiation of medical treatment and some lifestyle change among a sizeable minority of family members of patients with heart disease. This intervention approach needs to be assessed using a more definitive design with longer follow-up.