Intima-Medial Thickness Guidance of Primary Prevention in Relatives of Patients With Early onSet Atherosclerosis (IMPRESS)
Atherosclerotic Cardiovascular Disease, Cardiovascular Disease
About this trial
This is an interventional screening trial for Atherosclerotic Cardiovascular Disease
Eligibility Criteria
Inclusion Criteria:
- Have a first-degree relative (i.e. a mother, father, brother or sister) with premature (onset <65 years of age) atherosclerosis. This includes coronary artery disease/acute myocardial infarction, non-haemorrhagic stroke and peripheral vascular disease.
- Are classified as "intermediate risk" of experiencing a cardiovascular event in the next 5 years as determined via the Framingham Risk Equation 7, 22
- Live within a geographically accessible area for follow-up (i.e. within a 40km radius of the study centre)
- Are living independently in the community or their own home
- Are able and willing to provide written informed consent to participate in the study (this includes the ability to understand and speak English fluently and that the patient is mentally competent)
Exclusion Criteria:
- Pre-existing atherosclerotic disease
- Have been diagnosed with Type 1 or Type 2 Diabetes Mellitus
- Have contraindications to the use of statin medications (includes pregnancy and breastfeeding)
- Unable to provide written informed consent to participate in this study
- Have a terminal malignancy requiring palliative care, or limited life expectancy or any other medical condition (including pregnancy) that results in the belief (deemed by the Chief Investigators) that it is not appropriate for the patient to participate in this trial
- Participating in another clinical research trial
Sites / Locations
- National University HospitalRecruiting
- Novena heart CentreRecruiting
- Tan Tock Seng HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Lifestyle counseling
Usual care arm
All participants randomised into the IMPRESS Intervention group will undergo tailored health profiling.This individual assessment will be carried out within the clinic setting. The key elements of the IMPRESS intervention include: Promoting a healthy lifestyle Supporting lifestyle and risk modification Encouraging active self-management of risk and chronic disease Improving coordination of care Pharmacological therapy All the individuals in the intervention group will receive a comprehensive report on their risk status and ideal goals.
Usual Care Following the assessment of absolute cardiovascular risk, usual care participants will be provided a report outlining areas in which improvements could be made for the prevention of atherosclerotic burden. No restrictions will be made in respect to usual care management. As such, the prescription of standard medications for primary prevention of atherosclerotic burden based on individual risk factors is anticipated in 20-30% of usual care participants. At 18 months and three years those in the usual care arm will be invited to undergo repeat CIMT measurements, pathology, absolute risk score calculation and health-related questionnaires as part of the structured study follow-up