Ketola E, Mäkelä M, Klockars M
Northern Health Care Centre, Helsinki, Finland.
Br J Gen Pract. 2001 Apr;51(465):291-4.
The multiprofessional teams in Finnish health centres are well placed to carry out interventions aimed at the prevention of cardiovascular diseases.
To evaluate the effectiveness of an individually tailored multifactorial lifestyle intervention in primary care for individuals at high risk for cardiovascular disease.
A randomised controlled trial was conducted over 24 months with interim assessments at six and 12 months.
A health centre in Finland with a patient population of 11,000.
One hundred and fifty adults aged 18 to 65 years old with existing cardiovascular disease or multiple risk factors were randomised to active multiprofessional risk factor intervention or to standard care. The main outcome measure was a change in cardiovascular risk-factor score. Secondary outcomes were changes in blood pressure, weight, body-mass index, serum cholesterol, blood glucose, smoking cessation, and exercise habits.
The cardiovascular risk score decreased by 28% in the intervention group (23% in the control group), body weight decreased by 3.7% (2%) and total cholesterol decreased by 10.8% (6.5%), while time engaged in exercise increased by 39% (43%). Differences were not significant.
Cardiovascular risk levels of high-risk individuals decreased in both intervention and control groups. Primary care prevention should be targeted to high-risk persons. Long-term follow-up studies are needed.
芬兰健康中心的多专业团队非常适合开展旨在预防心血管疾病的干预措施。
评估针对心血管疾病高危个体的个性化多因素生活方式干预在初级保健中的效果。
进行了一项为期24个月的随机对照试验，在6个月和12个月时进行中期评估。
芬兰的一家健康中心，患者人数为11,000人。
150名年龄在18至65岁之间、患有心血管疾病或存在多种风险因素的成年人被随机分为积极的多专业风险因素干预组或标准护理组。主要结局指标是心血管风险因素评分的变化。次要结局指标包括血压、体重、体重指数、血清胆固醇、血糖、戒烟和运动习惯的变化。
干预组的心血管风险评分下降了28%（对照组下降了23%），体重下降了3.7%（对照组下降了2%），总胆固醇下降了10.8%（对照组下降了6.5%），而运动时间增加了39%（对照组增加了43%）。差异不显著。
干预组和对照组中高危个体的心血管风险水平均有所下降。初级保健预防应针对高危人群。需要进行长期随访研究。
