Abstract Body: Background: Hypertension and dyslipidemia disproportionately affect Black and Hispanic adults, contributing to cardiovascular disparities. Food-is-Medicine interventions combining produce prescriptions with nutrition education may prevent cardiovascular risk by improving lipid profiles. The THRIVE pilot examined whether a culturally tailored intervention could improve lipid profiles and PREVENT risk scores in Black and Hispanic adults with hypertension.
Method: THRIVE is a 6-month pilot randomized controlled trial enrolled 80 Black and Hispanic adults with hypertension. Participants received THRIVE intervention (produce prescriptions, dietitian coaching with motivational interviewing, and culturally tailored nutrition messaging) or enhanced usual care (standard produce bags without coaching). Laboratory measurements including comprehensive metabolic panel, lipid panel, hemoglobin A1C, and spot urine sodium and potassium were collected at baseline, 12, and 24 weeks. The AHA PREVENT equations were used to calculate 10-year risk for atherosclerotic cardiovascular disease (ASCVD), total cardiovascular disease (CVD), heart failure, coronary heart disease (CHD), and stroke. Outcomes were changes in lipid parameters and PREVENT risk scores. Between-group intervention effects were estimated using difference-in-differences (DiD) analysis via linear mixed-effects regression models.
Results: Among 80 participants (mean age 54.5±11.4 years, 56.8% female, 62.2% Black), THRIVE group showed decreased total cholesterol at 24 weeks (-10.4 mg/dL, p=0.041; Table 1), increased HDL at 12 weeks (5.7 mg/dL, p=0.046), and reduced LDL at 24 weeks (-12.6 mg/dL, p=0.004). Controls showed no significant lipid changes. Urinary sodium increased at 12 weeks (23.6 mEq/L, p=0.032) and potassium at 24 weeks (15.0 mEq/L, p=0.043) in THRIVE group, potentially reflecting improved dietary quality. PREVENT risk scores showed numerical reductions across most cardiovascular domains at 24 weeks in both groups, with trends toward greater reductions in controls, though no changes reached statistical significance (Figure 1).
Conclusion: The THRIVE pilot showed favorable within-group lipid profile improvements that may contribute to cardiovascular disease prevention in Black and Hispanic adults with hypertension. Larger definitive trials with extended follow-up are needed to determine whether these lipid improvements translate to meaningful reductions in cardiovascular risk and clinical events.