Change in coronary risk and coronary risk factor levels in couples following lifestyle intervention. The British Family Heart Study
S. D. Pyke, D. A. Wood, A. L. Kinmonth and S. G. Thompson
Medical Statistics Unit, London School of Hygiene and Tropical Medicine, England.
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.
