BackgroundCardiovascular diseases are the current leading causes of death and disability globally.ObjectiveTo assess the effects of a basic educational program for cardiovascular prevention in an unselected outpatient population.MethodsAll participants received an educational program to change to a healthy lifestyle. Assessments were conducted at study enrollment and during follow-up. Symptoms, habits, ATP III parameters for metabolic syndrome, and American Heart Association’s 2020 parameters of cardiovascular health were assessed.ResultsA total of 15,073 participants aged ≥ 18 years entered the study. Data analysis was conducted in 3,009 patients who completed a second assessment. An improvement in weight (from 76.6 ± 15.3 to 76.4 ± 15.3 kg, p = 0.002), dyspnea on exertion NYHA grade II (from 23.4% to 21.0%) and grade III (from 15.8% to 14.0%) and a decrease in the proportion of current active smokers (from 3.6% to 2.9%, p = 0.002) could be documented. The proportion of patients with levels of triglycerides > 150 mg/dL (from 46.3% to 42.4%, p < 0.001) and LDL cholesterol > 100 mg/dL (from 69.3% to 65.5%, p < 0.001) improved. A ≥ 20% improvement of AHA 2020 metrics at the level graded as poor was found for smoking (-21.1%), diet (-29.8%), and cholesterol level (-23.6%). A large dropout as a surrogate indicator for low patient adherence was documented throughout the first 5 visits, 80% between the first and second assessments, 55.6% between the second and third assessments, 43.6% between the third and fourth assessments, and 38% between the fourth and fifth assessments.ConclusionA simple, basic educational program may improve symptoms and modifiable cardiovascular risk factors, but shows low patient adherence.

Obesity is a widely recognized risk factor for several diseases, reaching an epidemic magnitude worldwide. Natural polyphenols may improve blood lipids and body weight, but their clinical relevance in the general population remains unclear. Thus, we aimed to analyze the relationship of intake of Ilex paraguariensis (I. paraguariensis) beverages to lipid profiles and body weight in a large patient population. Patients were recruited to participate in an educational program to change habits to a healthy lifestyle. Anamnesis, clinical and laboratory assessments were conducted at study enrollment and during follow‐up. I. paraguariensis beverages were defined according to preparation as obtained by repeated cold water extraction (CWE), hot water infusions, or water and sugar decoction. Heavy drinkers were defined as those persons consuming >1 L/day of one or more preparation types. Participants (N = 18,287) aged ≥18 years entered the study. Overall prevalence of I. paraguariensis consumption was 91.2%. All three forms were drunk by 35.7%, whereas CWE + hot water infusion and CWE alone by 28.4% and 14.5% participants, respectively. Heavy CWE drinkers had lower total cholesterol (191.4 ± 49.4 vs. 194.6 ± 48.3 mg/dl, p = .02) and lower low‐density lipoprotein cholesterol (118.6 ± 38.9 vs. 121.2 ± 47.1 mg/dl, p = .001), but body weight was higher (81.1 ± 16.8 vs. 77.2 ± 16.4 kg, p < .0001) compared with moderate drinkers. Fasting glucose was lower (104.5 ± 48.7 vs. 107.2 ± 49.5 mg/dl, p < .001), and consumption of carbohydrates was higher (36.3% vs. 28.7%, p < .001). A low‐lipids high‐body‐weight paradox could be observed in a population of heavy drinkers of I. paraguariensis beverages. Induced hypoglycemia and compensatory higher intake of refined carbohydrates may represent a possible cause.