The Lowering of Vascular Atherosclerotic Risk (LOVAR) program: an approach to modifying cerebral, cardiac, and peripheral vascular disease.
More than 1 million US citizens die of cerebral, cardiac, and peripheral vascular disease (collectively, CVD) each year. Basic science and clinical outcome research aimed at reducing the burden of this illness is widespread, but the knowledge gleaned from controlled trials has not fully translated into everyday clinical practice and care of patients with CVD and their inherent risk factors. The Lowering of Vascular Atherosclerotic Risk (LOVAR) program was a 5-year observational study that evaluated the feasibility of a high-intensity multidisciplinary program of risk factor reduction in a population with known symptoms of CVD. The population comprised patients with documented clinically symptomatic cerebral, cardiac, or peripheral vascular disease and at least two modifiable risk factors for stroke, myocardial infarction, or peripheral vascular occlusive disease. Final outcomes were evaluated by comparing primary and secondary end points and quality of life. A total of 271 patients were enrolled in the intervention group, and 242 were enrolled in the standard care group (control). At 3 years, significant improvements in several risk factors were seen in the intervention group, with no significant improvements for the control group. The rate of patient retention was 95% at 3 years, and overall rates of physician and patient satisfaction were high. We believe that the Lowering of Vascular Atherosclerotic Risk program is generalizable to a sufficiently motivated population targeted as high risk for vascular disease.