Italian College of General Practitioners, Florence, Italy.
Eur J Gen Pract. 2009;15(3):136-40. doi: 10.3109/13814780903362560.
To evaluate the long-term effectiveness of lifestyle counselling for low-moderate cardiovascular (CV) risk subjects in primary care.
Prospective comparison of baseline vs post-intervention, and comparison of enrolled patients vs control subjects extracted from a large primary care database.
94 general practices in Italy.
All the 20-70-year-old hypercholesterolaemic subjects who did not qualify for statin treatment according to the guidelines and who were seen on 12 predetermined working days; 713 patients; 94 general practitioners.
Short (5-10 min) educational intervention (qualitative dietary advice, encouraging walking or other aerobic physical activities); handing out simple dietetic advice at physician discretion.
Total cholesterol level and global CV risk calculated according to the Framingham equation.
Total cholesterol and global CV risk (10 years) decreased by 0.31 mmol/l (p < 0.0001, 95% CI 0.23-0.40) and 1.35% (p < 0.01, 95% CI -1.73 to -0.97), respectively, after a 54-month follow-up. Enrolled patients showed a greater total cholesterol decrease than control patients: 2.24% (p < 0.05, 95% CI 0.58-3.91%).
A simple, office-based, long-term, lifestyle counselling programme produces a small, but clinically significant reduction of total cholesterol and of global CV risk. This result should encourage GPs to systematically offer simple, unstructured lifestyle counselling to all their patients.
评估初级保健中针对低中度心血管（CV）风险人群的生活方式咨询的长期效果。
前瞻性比较基线与干预后，以及从大型初级保健数据库中提取的入组患者与对照患者的比较。
意大利 94 家普通诊所。
所有不符合指南规定的他汀类药物治疗标准的 20-70 岁高胆固醇血症患者，以及在 12 个预定工作日就诊的患者；713 例患者；94 名全科医生。
简短（5-10 分钟）的教育干预（定性饮食建议，鼓励步行或其他有氧运动）；根据医生的判断发放简单的饮食建议。
根据 Framingham 方程计算的总胆固醇水平和总体 CV 风险。
总胆固醇和总体 CV 风险（10 年）在 54 个月的随访后分别下降了 0.31mmol/L（p < 0.0001，95%CI 0.23-0.40）和 1.35%（p < 0.01，95%CI -1.73 至-0.97）。入组患者的总胆固醇下降幅度大于对照组患者：2.24%（p < 0.05，95%CI 0.58-3.91%）。
一种简单、基于办公室、长期的生活方式咨询方案可使总胆固醇和总体 CV 风险有较小但具有临床意义的降低。这一结果应鼓励全科医生系统地向所有患者提供简单、非结构化的生活方式咨询。
