Patients in danger of heart disease and stroke reduced their risk by receiving health "report cards" and telephone counselling, B.C. researchers found.

The researchers studied 611 people ages 45 to 64 living in the Fraser Health Region, which includes Burnaby, White Rock, Surrey and other communities south and east of Vancouver.

The participants were split into two groups: one consisted of people with diagnosed cardiovascular disease and the other group was at high risk of cardiovascular disease.

Heart disease and stroke are responsible for 36 per cent of deaths in Canada. The purpose of the study was to determine whether people at high risk of cardiovascular disease would benefit from one-on-one counselling and by receiving their health risk profiles in the mail.

Andrew Wister, one of the study's authors and chair of the gerontology department at Simon Fraser University, said the study was also meant to act a model for a community-based health-care program that could be implemented at a fairly low cost to lower a population's heart and stroke risks.

The intervention consisted of a health report card that was sent to the participants and their family doctors. This included a profile of risks such as high cholesterol, systolic blood pressure, diabetes and smoking status. Physical activity, body mass index, waist circumference, nutrition status, stress level and health confidence were also factored in.

The other component of the intervention was a telephone discussion between a lifestyle counsellor — trained as a kinesiologist and well-versed in cardiovascular disease prevention — and the participants. Two kinesiologists performed all 611 interventions.

"Two people did it all, one full-time and one part-time," Wister told CBCNews.ca on Friday. "You could reach a lot of people if you were doing this on a continual basis."

The counsellors discussed the participants' health reports and nutritional and exercise modifications, and encouraged them to set goals such as losing weight and lowering blood pressure.

The counselling sessions occurred within 10 days of a participant receiving the health report card and every six months following for approximately 30 minutes per session — up to 60 minutes a year.

Most patients visited their physicians twice during the year to have their medications reviewed and to have laboratory tests done for lipid and liver enzyme levels measured.

Psychological, physical improvements noted

At year's end, the group that received the intervention showed a "statistically significant" reduction in global cardiovascular risk, relative to the control group, the researchers said.

This association remained statistically significant after adjustment for age, sex, education and income.

Blood pressure and cholesterol dropped the most among the participants, said Wister.

He also noted that individuals began making better nutritional choices and were more "health confident."

"They seemed to change what they were eating, which is a good thing these days because of the obesity rates," he said.

"The problem is we're not doing enough as individuals and we often wait until we get into problems before we see a doctor and before we're treated."

Wister said he didn't know exactly why the phone calls and mailed health report cards worked in reducing the risks of participants.

"It could have been the phone call, it could have been the report card, it could be some combination of them talking to their doctors, it could be a number of things."

Wister said he now wants to design a study involving a mailed-out report card, web-based counselling and a telephone/internet coach to see the impact on cardiovascular risk reduction.

Worthwhile investment

Wister also said the study is continuing. Researchers plan to track the people in the study and their medical data — hospital records, drug costs, doctors' costs — over the next two years.

"We're going to follow them until 2009 and then we're going to calculate the cost savings."

He said he suspects the savings to the health-care system would be significant.

"If you reduce the number of angioplasties, bypasses, the major surgeries — even if you reduce a very small percentage, they are extremely expensive. And so the cost savings could be huge."

But he said it is something that needs to be investigated over a long period before the effects — cost savings included — are seen.

The results of the first year of the study are to be published in Tuesday's issue of the Canadian Medical Association Journal.