Engberg Marianne, Christensen Bo, Karlsmose Bo, Lous Jorgen, Lauritzen Torsten
Department of General Practice, University of Aarhus, Vennelyst Blvd 6, Dk-8000 Aarhus C, Denmark.
J Fam Pract. 2002 Jun;51(6):546-52.
To investigate the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of a random population of patients.
A population-based, randomized, controlled, 5-year follow-up trial conducted in a primary care setting.
The study group consisted of 2000 patients, randomly selected middle-aged men and women aged 30 to 50 years from family practices in the district of Ebeltoft, Denmark. Of these patients, 1507 (75.4%) agreed to participate. Patients were randomized into (1) a control group who did not receive health screenings, (2) an intervention group that received 2 health screenings, (3) an intervention group that received both the 2 screenings and a 45-minute follow-up consultation annually with their general practitioner.
Cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and tobacco use.
After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups compared with the control group. The improved outcome was greater in the baseline risk groups. The number of patients with elevated CRS in the intervention groups was approximately half the number of patients with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone.
Health screenings reduced the CRS in the intervention groups. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half that expected, based on the prevalence/proportion in a population not receiving the health checks (the control group). The impact of intervention was higher among at-risk individuals. Consultations about health did not appear to improve the cardiovascular profile of the study population.
探讨一般健康筛查以及与全科医生的讨论对随机选取的患者群体心血管风险状况的影响。
在初级保健机构中进行的一项基于人群的随机对照5年随访试验。
研究组由2000名患者组成，他们是从丹麦埃贝尔托夫特地区的家庭诊所中随机选取的年龄在30至50岁之间的中年男性和女性。其中，1507名患者（75.4%）同意参与。患者被随机分为：（1）未接受健康筛查的对照组；（2）接受2次健康筛查的干预组；（3）既接受2次筛查又每年与全科医生进行45分钟随访咨询的干预组。
心血管风险评分（CRS）、体重指数（BMI）、血压、血清胆固醇、呼出气体中的一氧化碳以及烟草使用情况。
5年后，干预组的CRS、BMI和血清胆固醇水平低于对照组。在基线风险组中改善效果更显著。干预组中CRS升高的患者数量约为对照组中CRS升高患者数量的一半。这种差异并非药物使用所致。接受筛查后咨询的组与仅接受健康筛查的组之间没有差异。
健康筛查降低了干预组的CRS。经过5年随访，心血管风险升高的人数约为未接受健康检查人群（对照组）患病率/比例预期人数的一半。干预对高危个体的影响更大。关于健康的咨询似乎并未改善研究人群的心血管状况。
