Family-based approach in cardiovascular risk reduction

The results of the PROLIFIC trial by Panniyammakal Jeemon and colleagues1Jeemon P Harikrishnan S Ganapathi et al.Efficacy a family-based cardiovascular risk reduction intervention in individuals with family history premature coronary heart disease India (PROLIFIC): an open-label, single-centre, cluster randomised controlled trial.Lancet Glob Health. 2021; 9: e1442-e1450Summary Full Text PDF PubMed Scopus (4) Google Scholar published Lancet Global Health have potential to improve health people living low-income middle-income countries. colleagues’ study is attempt control factors for at level, either patient alone or members. Adherence lifestyle compliance drugs essential factors. Considering escalating burden diseases countries, trial1Jeemon substantially contributes towards primary secondary prevention disease. colleagues showed that 13 home visits repeated reminders had positive effect on adhering therapy controlling such as unhealthy diet, tobacco cessation, blood pressure monitoring, sugar emphasis daily exercise. effectiveness was shown outcome results: 2-year follow-up, lower than 140/90 mm Hg, fasting plasma glucose 110 mg/dL, low-density lipoprotein cholesterol 100 abstinence from achieved 514 (64%) 803 participants group 379 (46%) 819 partcipants usual care group, after adjustment clustering baseline (odds ratio 2·2, 95% CI 1·7–2·7; p<0·0001).1Jeemon Proactive trained workers health. Training better level can prevent development clinical Heart young age creates economic not only family, but also society country due cost health-care services, medicines, lost productivity. mentioned this (USD 47·4 per year) much spent if someone diagnosed If low-cost incorporated into existing community scheme, it more likely be effective standard care. Research interventions management its infancy present important step developing realistic systematic trials future. Achieving changes adherence these challenging. evidence-based pharmacotherapy modification associated reduced incidence As time passes index event, becomes less. To adherence, repetitive physical presence worker digital health-based seems beneficial. In multicentre India, could medicine modifications, markers Acute Coronary Syndrome Indian patients.2Xavier D Gupta R Kamath al.Community worker-based change acute syndrome: multicentre, open, Diabetes Endocrinol. 2016; 4: 244-253Summary (76) However, very few studies exist linking behavioural outcomes benefits morbidity mortality. done members patients Younger often This association between environmental indicates possible genetic susceptibility. Familial hypercholesterolemia one most common disorders lipid metabolism, which underdiagnosed, undertreated cause Results previous 15% who myocardial infarction familial hypercholesterolemia,3Sawhney JPS Prasad SR Sharma M al.Prevalence artery admitted tertiary hospital North India.Indian J. 2019; 71: 118-122Crossref (9) similar 10% prevalence USA 14·7% condition Australia.4Singh A Collins BL al.Familial among adults infarction.J Am Coll Cardiol. 73: 2439-2450Crossref (42) Scholar, 5Pang J Poulter EB Bell DA al.Frequency early-onset unit.J Clin Lipidol. 2015; 703-708Summary (61) Once individual hypercholesterolemia, other should identified cascade screening profiling rather testing, neither easily available nor affordable. Cascade has been proven successful initiative countries.6Setia N Saxena Sawhney Verma IC hypercholesterolemia: children relatives affected.Indian Pediatr. 2018; 85: 339-343Crossref (12) 7Knowles JW Rader DJ Khoury MJ use testing.JAMA. 2017; 318: 381-382Crossref (98) disease, early all share factors, good option study, evaluating encourage future assess level. Family-focused help act team managing ways are consistent their beliefs. Interventions focused treatment factor family-behaviour variables. suggests relationships, education members, might approach disease.8Satin W La Greca AM Zigo MA Skyler JS adolescence: effects multifamily parent simulation diabetes.J Pediatr Psychol. 1989; 14: 259-275Crossref (141) Educating regarding importance progression vascular (coronary cerebrovascular peripheral disease). future, compare versus mobile interventions. JPSS reports honoraria lectures presentation Novartis, Pfizer, Boehringer Ingelheim, Astrazeneca, Lupin, Merc, Torrent. KM declares no competing interests. Efficacy trialThe total observed substantial public impact preventing events. Full-Text Open Access