4. Discussion
cardiovascular disease
HEART, CARDIOVASCULAR DISEASE
In this study, we evaluated the (cost-)effectiveness on population level of offering referral to the lifestyle programme “Healthy Heart” in a high-risk cardiovascular disease population in primary care. The most important finding is that for both the shorter (3–6 months) and longer term (12–24 months), there were no differences in cardiovascular or lifestyle behavioural outcomes between the control period versus the intervention period on a population level. Furthermore, there was no effect on number of cardiovascular-related practice consultations and offering the Healthy Heart programme did not improve QALYs or reduce costs in the intervention period. Although a majority of the participants set a goal to change their lifestyle behaviour, only participants with a goal to improve their diet quality slightly improved their diet quality in the short term, but not in the long term.