Ps-c02-6: a protocol paper for the new health guidance initiatives of heart failure aggravation prevention projects for urban residents in japan

Background: At the end of 2021, Japan's ageing rate was 29.1%, the highest globally, and is steadily increasing. Heart failure is a terminal manifestation of various heart diseases, but there have been very few epidemiological studies of heart failure among residents in Japan. We have started a joint project with Suita city and its Medical Association to prevent heart failure, which implements the findings of the Suita study in urban area residents. Objective: The purpose of this project is to contribute to the prevention of heart failure as well as overall cardiovascular disease, cancer, and dementia by providing health guidance according to the level of heart failure. Methods: The examiners in this project agree to participate in the “Long-term Follow-up Study on Prognostic Factors for Heart Failure in Suita City Health Examination” at the time of their health examination in Suita from November 2020 to October 2022. Predict the onset of potential heart failure using a predictive tool that adds NT-proBNP to the risk score for coronary artery disease and atrial fibrillation. There are four groups of subjects: low, middle, and high risks. For high-risk people, we will provide medical cooperation as a treatment required. Subjects classified as middle risk will be given health guidance, and those classified as high risk will be recommended to consult a doctor. Those at middle risk are stratified into two categories: individual guidance and group guidance programs, according to their risk of potential heart failure. We developed the original textbook, “Lifelong Health Support 10.” Of the 26,267 participants in total (including 3,852 duplicates), 591 were given group guidance and 285 were given individual guidance (as of March 2022). Blood pressure and body composition are measured at the first interview in the individual guidance program, and lifestyle habits according to the lifelong health support 10 are checked. We set behavioral goals for each participant. At the time of 1 and 2 months later, a mail or letter support is provided, and after 3 months, blood pressure and body composition are measured and biochemical tests (HbA1c, LDL-c, NT-proBNP), and evaluation of lifestyle improvement. In the group guidance program, lifestyle checks and action goals are set at the time of initial guidance, and lifestyle improvement evaluations are conducted three months later. In both cases, the final review will be evaluated using the results of the health checkup items and risk scores for the following year.