Change in coronary risk and coronary risk factor levels in couples following lifestyle intervention. The British Family Heart Study

Abstract

Objectives: To measure the extent to which changes in cardiovascular risk factors were correlated among married couples following a 1-year primary care, family-centered, cardiovascular lifestyle intervention program and to identify couples who benefited most from this prevention program.

Design: Observational study.

Setting: Thirteen primary care centers in 13 towns in Britain.

Participants: A total of 1477 men aged 40 to 59 years and their female partners who attended a family health checkup in 1991 to 1992 from randomly ordered invitations to registered families. After 1 year, 1204 (82%) partner pairs were rescreened.

Main outcome measures: One-year changes in cigarette smoking, systolic blood pressure, serum cholesterol level, blood glucose level, and a total coronary risk score.

Results: Comparing men and women partners, baseline values and 1-year changes in overall coronary risk score (Pearson r = 0.27 and r = 0.20, respectively), cigarette smoking, body mass index, systolic blood pressure, cholesterol levels, and glucose levels were all positively correlated (all P < .001 except smoking cessation, P = .03). Changes in cholesterol levels and systolic blood pressure were also associated with partner's baseline measurement (P < or = .01 in both men and women).

Conclusions: Men and women who benefit most from risk factor reductions have partners who also tend to benefit most. Conversely, men and women who enjoy little or no benefit have partners who tend to have similarly small benefits. It is likely that lifestyle intervention targeted at men and women as couples rather than as individuals may result in a greater reduction in cardiovascular risk factors, possibly through mutual reinforcement of lifestyle changes.