Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN.
CareHere, Inc, Nashville, TN.
Am Heart J. 2014 Jan;167(1):93-100. doi: 10.1016/j.ahj.2013.09.019. Epub 2013 Oct 19.
Cardiovascular disease (CVD) is the leading cause of morbidity, mortality, and cost in Western society. Employer-sponsored work health programs (WHPs) and Web-based portals for monitoring and providing guidance based on participants' health risk assessments are emerging, yet online technologies to improve CVD health in the workplace are relatively unproven. We hypothesized that an online WHP, comprehensively addressing multiple facets of CVD, can be successfully implemented and improve the health of participants.
A cohort of employees in Tennessee (n = 1,602) was subjected to a health risk assessment at baseline. Those who did not meet all 5 healthy benchmarks (n = 836)-body mass index, blood pressure, glucose, total cholesterol, and smoking status-were prospectively assigned to a Web-based personal health assistant and had repeat measurements taken at 90 days.
Of those who both completed the personal health assistant program and underwent baseline plus 90-day assessments (508/836, 61%), 75% were female, mean age was 46.5 ± 11.1 years, and the mean number of risk factors at baseline was 1.1 ± 0.9 with a mean 10-year Framingham Risk Score of 2.9%. This cohort demonstrated a significant reduction in total cholesterol (P < .0001), low-density lipoprotein cholesterol (P < .0001), triglycerides (P < .0001), systolic blood pressure (P = .009), glucose (P = .004), weight (P = .001), and body mass index (P = .001). Most of the participants improved at least 1 risk factor. Framingham Risk 10-year cardiovascular risk percentages were significantly reduced (P = .003).
This study in a prospective cohort of community-dwelling employees suggests that an online WHP can provide a viable means to improve surrogates of CVD risk factors.
心血管疾病(CVD)是西方社会发病率、死亡率和医疗成本的主要原因。雇主赞助的工作健康计划(WHPs)和基于网络的门户,用于根据参与者的健康风险评估进行监测和提供指导,正在出现,但改善工作场所心血管健康的在线技术相对未经证实。我们假设,全面解决 CVD 多个方面的在线 WHP 可以成功实施并改善参与者的健康状况。
田纳西州的一组员工(n = 1602)在基线时接受了健康风险评估。那些不符合所有 5 个健康基准(n = 836)-体重指数、血压、血糖、总胆固醇和吸烟状况-的人被前瞻性分配到一个基于网络的个人健康助手,并在 90 天内进行重复测量。
在完成个人健康助手计划并进行基线加 90 天评估的人中(508/836,61%),75%为女性,平均年龄为 46.5 ± 11.1 岁,基线时的平均危险因素数为 1.1 ± 0.9,平均Framingham 风险评分 10 年为 2.9%。该队列的总胆固醇(P <.0001)、低密度脂蛋白胆固醇(P <.0001)、甘油三酯(P <.0001)、收缩压(P =.009)、血糖(P =.004)、体重(P =.001)和体重指数(P =.001)均显著降低。大多数参与者至少改善了 1 个危险因素。Framingham 风险 10 年心血管风险百分比显著降低(P =.003)。
这项对社区居住员工的前瞻性队列研究表明,在线 WHP 可以为改善 CVD 危险因素提供可行的方法。