Effects of a Physician-Led Primary Prevention For Cardiovascular Risk Reduction Among Institutional Workers: Evidence From a Randomized Control Trial
Keywords:
Cardiovascular risk, Primary Prevention, Physician-ledAbstract
Cardiovascular diseases (CVDs) account for over one-third of adult deaths in Nigeria, with a rising burden among individuals under 60 years. Primary prevention remains a cost-effective approach to reduce CVD risks. To evaluate the effectiveness of a physician-led primary prevention programme in reducing cardiovascular risks among vulnerable workers. A two-arm randomized controlled trial was conducted among 223 civil servants with moderate-to-high CVD risks, selected from 1,778 screened participants across 32 government institutions. Participants were randomized into an intervention group (n=118) that received physician-led, WHO-based total cardiovascular risk management, including risk assessment, lifestyle counselling, and pharmacologic control, and a control group (n=105) that received usual care from their primary caregivers. Participants were followed up for six months. The primary outcome was change in the 10- year absolute CVD risk score (Framingham tool). Secondary outcomes included changes in systolic blood pressure (SBP), fasting blood sugar (FBS), and body mass index (BMI). Data were analyzed using paired and independent t-tests at α=0.05. Baseline mean age was similar across groups (52±6 years). The intervention group showed a greater FBS reduction (-19.3 mg/dl; 95% CI: -36.7 to -1.9; p<0.05) and modest change in mean CVD risk score (-0.24%; 95% CI: -2.1
to 1.6; p>0.05) compared to controls. Significance within-group improvements were observed in SBP (-5.0 mmHg), FBS (-9.8 mg/dl), and BMI (-0.8 kg/m²) in the intervention arm. Although changes in overall CVD risk were not statistically significant, the physician-led intervention effectively improved major modifiable risk factors, supporting its potential for scalable workplace CVD prevention in Nigeria.
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