Stocks Nigel P, Broadbent Jessica L, Lorimer Michelle F, Tideman Philip, Chew Derek P, Wittert Gary, Ryan Philip
Discipline of General Practice, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, University of Adelaide, Adelaide, South Australia, Australia.
Data Management and Analysis Centre, University of Adelaide, Adelaide, South Australia, Australia.
BMC Fam Pract. 2015 Sep 3;16:116. doi: 10.1186/s12875-015-0328-4.
This study aimed to increase cardiovascular disease (CVD) risk assessment in adult first degree relatives of patients with premature ischaemic heart disease (PIHD) using written and verbal advice.
A prospective, randomised controlled trial.
Cardiovascular wards at three South Australian hospitals. Cardiovascular risk assessments were performed in general practice.
Patients experiencing PIHD (heart disease in men aged <55 years or women aged < 65 years) and their first degree relatives.
Patients distributed either general information about heart disease and written advice to attend their general practitioner (GP) for CVD risk assessment or general information about heart disease only, to their first degrees relatives.
The primary outcome was the proportion of relatives who attended their GP for CVD risk assessment within 6 months of the patients' PIHD event.
One hundred forty four patients were recruited who had 541 eligible relatives; 97/541 (18 %) of relatives agreed to participate. A larger number of intervention 41/55 (75 %) than control group 9/42 (21 %) [difference 53 %, 95 % CI 36 % - 71 %] relatives attended their GP for a CVD assessment, and 34 % of these had moderate to very high 5-year absolute risk for CVD.
This low cost intervention demonstrates that individuals who have a family history of PIHD and are at moderate or high risk of CVD can be targeted for early intervention of modifiable risk factors. Further research is required to improve the uptake of the intervention in relatives.
The trial was registered with the Australian Clinical Trials Registry (ACTRN), Registration ID 12613000557730 .
本研究旨在通过书面和口头建议，提高早发性缺血性心脏病（PIHD）患者成年一级亲属的心血管疾病（CVD）风险评估水平。
一项前瞻性随机对照试验。
南澳大利亚州三家医院的心血管病房。心血管风险评估在全科医疗中进行。
患有PIHD（男性年龄<55岁或女性年龄<65岁的心脏病）的患者及其一级亲属。
患者向其一级亲属分发关于心脏病的一般信息以及前往全科医生（GP）进行CVD风险评估的书面建议，或者仅分发关于心脏病的一般信息。
主要结局是亲属在患者发生PIHD事件后6个月内前往GP进行CVD风险评估的比例。
招募了144名患者，他们有541名符合条件的亲属；97/541（18%）的亲属同意参与。干预组中有更多亲属41/55（75%）前往GP进行CVD评估，而对照组为9/42（21%）[差异53%，95%CI 36% - 71%]，其中34%的亲属5年CVD绝对风险为中度至非常高。
这项低成本干预措施表明，有PIHD家族史且处于CVD中度或高风险的个体可作为可改变风险因素早期干预的目标人群。需要进一步研究以提高亲属对该干预措施的接受度。
该试验在澳大利亚临床试验注册中心（ACTRN）注册，注册号为12613000557730 。
