Dr. Appel said the trial was not set up to look at these outcomes, however evidence from other studies suggests that in a prediabetic population, a 5% loss in body weight will reduce the incidence of diabetes by 40%-50%. A reduction in systolic blood pressure also can be expected. Although patients were on medications for this, there was a relationship between systolic blood pressure reduction and weight loss across the entire study population, he said.
At baseline, 76% of patients had hypertension, 68% hypercholesterolemia, 23% diabetes, and 33% metabolic syndrome. Their mean age was 54 years, 64% were women, 56% were white and 41% were black.
The cost of such a remote program depends on how it is rolled out, but that the coaching staff was the biggest driver of expenses at about $600-$800 for the 2 years, Dr. Appel noted. Johns Hopkins is working on implementing the remote intervention and Healthways is expected to make the program commercially available, he said in an interview.
The remote intervention, consisting of phone counseling, an interactive website, and physician support, "has the potential for widespread implementation and should be applicable to the management of other chronic conditions," he told the attendees.
The trial was funded by the National Heart, Lung, and Blood Institute, with data analytic support provided by the National Institute of Diabetes and Digestive and Kidney Disease. Dr. Appel reported no conflicts of interest.