Telemedicine Intervention to Improve Long-Term Risk Factor Control and Body Composition in Persons with High Cardiovascular Risk: Results from a Randomized Trial

Background: Telehealth strategies are increasingly used to support people at high cardiovascular risk long-term, but is it unclear if these interventions are effective at improving cardiovascular risk. Objective: To evaluate the effects of a telemedicine technology-based program on risk factor control and body composition in patients at high cardiovascular risk. Methods: This is a population based randomized controlled trial. 100 patients at high and very high cardiovascular risk were randomly assigned to a telemedicine technology-based program consisting of: Comprehensive counseling on risk factors delivered by a physician; biweekly remote support via phone delivered by a trained nurse during the first three months after enrollment; and a control group receiving routine care with individual single-session counseling on patients' current risk factors without further support. The follow-up period was 1 year. Results: Mean age of participants was 59.9 +/- 4.5 years, 80% were women. Weight (-0.582; p < 0.001), waist circumference (-0.429; p = 0.01), body mass index (-0.216; p < 0.001) diastolic blood pressure (-0.881; p = 0.04), total cholesterol (-0.149; p = 0.01) and LDL cholesterol (-0.123; p = 0.003) were lower in the intervention group compared to the control group after 12-month. Body fat mass was also lower (-0.352; p = 0.01) and lean mass was higher (0.92; p = 0.03) in the intervention group. Anxiety scores (-2.5; p < 0.002) and depression scores (-2.6; p < 0.001) were also lower in the intervention group. Conclusions: Among older people at high cardiovascular risk, the addition of telehealth strategies using remote support by phone calls over a period of 3 month resulted in small but significant improvements of cardiovascular risk factors, body composition, anxiety, and depression which are maintained long-term. Such telehealth strategies may offer an advantage over standard institution-based interventions.

Automated summary

This study demonstrates that among older individuals at high cardiovascular risk, the use of telehealth strategies can lead to significant improvements in cardiovascular risk factors, body composition, anxiety, and depression, which can be maintained long-term.