PCV53 EFFECTIVENESS OF A CARDIOVASCULAR RISK MANAGEMENT PROGRAM IN THE INCIDENCE OF CARDIOVASCULAR EVENTS IN A LOW-INCOME POPULATION FROM THE CARIBBEAN REGION OF COLOMBIA

Evaluate the effectiveness of a cardiovascular risk management program “De Todo Corazon” (DTC) on the incidence of cardiovascular events (CVE) in a low-income population from the Caribbean region of Colombia. This was a retrospective cohort study. Patients with 20 to 76 years affiliated to insurer company and enrolled to the DTC program were considered as the study population. The data source was an administrative database of all 128,263 patients between Jan 2015 and Dec 2018. The main outcome was the reduction in the risk of a CVE (stroke, AMI or CHF) based in the time-person exposed to the intervention. Four different time thresholds were considered for stablishing exposure status: six months, one year, two years and four years. Propensity score-weighted Cox regression models were used to evaluate the association between exposure to the program and the incidence of CVE. Exposed to the DTC program had a significantly lower risk of a cardiovascular outcome in the 1-year ( HR : 0.878, (IC95% 0.770 – 1.001), p = 0.051), 2 years ( HR : 0.517, (IC95% 0.472 – 0.565), p < 0.001) and 4 years ( HR : 0.447, (IC95% 0.418 – 0.479), p < 0.001) but not in the 6-month (HR : 1.046, (IC95% 0.879 – 1.245), p = 0.612). Control of blood pressure was associated to a lower risk of a CVO in all scenarios of exposure (6-month = HR : 0.373, (IC95% 0.339 – 0.410), 1-year = HR : 0.375 (IC95% 0.327 – 0.390), 2 years = HR : 0.366 (IC95% 0.329 – 0.407), 4 years = HR : 0.358 (IC95% 0.332 – 0.385)(p<0.001). The DTC program was shown to be effective in the reduction of the risk of a CVE after one year of exposure. Population-based interventions may be an important strategy for the prevention of CVE in low-income individuals.