Department of Health Sciences and the EMGO + Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.
BMC Cardiovasc Disord. 2012 Sep 10;12:71. doi: 10.1186/1471-2261-12-71.
The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established.The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention programme of 6 months duration aimed at maximum reduction of cardiovascular risk factors in patients with cardiovascular disease (CVD) compared with usual care.
A single centre, two arm, parallel group randomised controlled trial was performed. Patients with stable established CVD and at least one lifestyle-related risk factor were recruited from the vascular and cardiology outpatient departments of the university hospital. Blocked randomisation was used to allocate patients to the intervention (n = 71) or control group (n = 75) using an on-site computer system combined with allocations in computer-generated tables of random numbers kept in a locked computer file. The intervention group received the comprehensive lifestyle intervention offered in a specialised outpatient clinic in addition to usual care. The control group continued to receive usual care. Outcome measures were the lifestyle-related cardiovascular risk factors: smoking, physical activity, physical fitness, diet, blood pressure, plasma total/HDL/LDL cholesterol concentrations, BMI, waist circumference, and changes in medication.
The intervention led to increased physical activity/fitness levels and an improved cardiovascular risk factor profile (reduced BMI and waist circumference). In this setting, cardiovascular risk management for blood pressure and lipid levels by prophylactic treatment for CVD in usual care was already close to optimal as reflected in baseline levels. There was no significant improvement in any other risk factor.
Even in CVD patients receiving good clinical care and using cardioprotective drug treatment, a comprehensive lifestyle intervention had a beneficial effect on some cardiovascular risk factors. In the present era of cardiovascular therapy and with the increasing numbers of overweight and physically inactive patients, this study confirms the importance of risk factor control through lifestyle modification as a supplement to more intensified drug treatment in patients with CVD.
ISRCTN69776211 at http://www.controlled-trials.com.
在接受心脏保护药物治疗以改善心血管风险状况的患者中，生活方式干预的额外益处尚未完全确定。目的是评估 6 个月的目标驱动多学科结构化生活方式干预计划的有效性，该计划旨在最大限度地降低心血管疾病（CVD）患者的心血管风险因素，与常规护理相比。
进行了一项单中心、双臂、平行组随机对照试验。从大学医院的血管和心脏病门诊部门招募了患有稳定的已确诊 CVD 和至少一种与生活方式相关的风险因素的患者。使用现场计算机系统与保存在锁定计算机文件中的随机数生成表的计算机生成表中的分配相结合，对患者进行分组（n=71）或对照组（n=75）的分组。干预组在专门的门诊诊所接受综合生活方式干预，同时接受常规护理。对照组继续接受常规护理。主要结局是与生活方式相关的心血管风险因素：吸烟、体力活动、体质、饮食、血压、血浆总/HDL/LDL 胆固醇浓度、BMI、腰围和药物变化。
干预导致体力活动/体质水平提高，心血管风险因素谱改善（BMI 和腰围降低）。在这种情况下，常规护理中通过预防性治疗 CVD 对血压和血脂水平的心血管风险管理已经接近最佳，反映在基线水平。其他任何风险因素都没有显著改善。
即使在接受良好临床护理和使用心脏保护药物治疗的 CVD 患者中，综合生活方式干预对某些心血管风险因素也有有益影响。在心血管治疗的新时代，随着超重和体力活动不足患者的数量不断增加，本研究证实了通过生活方式改变控制风险因素作为 CVD 患者强化药物治疗的补充的重要性。
ISRCTN69776211 在 http://www.controlled-trials.com。
