Valentin Fuster, MD, PhD: FAMILIA Study


How preventive care strategy adherence could bolster heart disease risk reduction in entire families.

An assessment into the effect of group and individual therapy for heart disease prevention in families from Harlem, NY, showed little difference between either method of weight, diet, exercise, and blood pressure management. Rather, the only true factor in adult heart disease prevention was adherence to a strategy.

The adult-based results of the FAMILIA trial, presented at the American Heart Association (AHA) 2019 Scientific Sessions in Philadelphia this week, showed the value of comprehensive, direct, preventive healthcare measures in entire families from an underserved area.

In an interview with MD Magazine® study author Valentin Fuster, MD, PhD, Physician-in-Chief and Head of the Cardiovascular Institute at Mount Sinai, detailed the study findings and shared his perspective on the value of family-based preventive care.

MD Mag: What were the details of the FAMILIA study?

Fuster: The FAMILIA study is in an underserved area of New York—Harlem. Six hundred families, where we tested the children and the adults on 2 preventive strategies.

In the presentation at the AHA, we just dealt with the adult population. Six hundred parents or caregivers were divided into 3 groups: one group, for 4 years, served as control. The second group had group therapy—8-10 times, they joined groups of 10, and they discussed their weight, blood pressure, exercising, and they helped each other. The third group was actually coaching, individually.

The primary endpoint was whether these 2 groups had a significant difference at 2 years of follow-up, versus the control group, in terms of weight, exercise, blood pressure, smoking, etc. And there was no significant difference.

The great difference was in the secondary endpoints—that those who would adhere to the program, that those who attended 4-6 of the sessions versus those who did not adhere to the program, was a very significant difference. It was very favorable for those who attended.

The second issue is, one of the aspect by which people were motivated to attend was to know what their arteries looked like in a screening. Through a non-invasive imaging process, we could tell who had some disease, and who didn't. This had a very significant impact.

And most importantly, the positive results were sustainable. One year after we entered the patients—one year of control versus 2 years of intervention—the results were still very favorable to the group who had adhered to the attending physicians.

MD Mag: What is the significance of it being an inner-city patient population?

Fuster: Well, we have done 3 studies. One is with a population that is underserved—that's the population here in Harlem. The other was in Bogota, Colombia with 1500 children, and that was in a rather low economic status. And the other was in Spain, with a middle-to-high economic status.

It was very surprising. The results were fascinating, in terms that the best results we're seeing are here, in Harlem, in those who adhere to the program that we have.

I think the families feel we care about them, that we care about their children, because this program is not only for parents but also for children. That in of itself is a social motivation in adherence.

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