University of Lille, Lille, France.
Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York.
Arthritis Care Res (Hoboken). 2017 Aug;69(8):1209-1216. doi: 10.1002/acr.23128. Epub 2017 Jun 26.
To determine if a cardiovascular disease (CVD) prevention counseling program for lupus patients decreases the prevalence of CVD risk factors.
The assessment phase of a 3-year CVD prevention counseling program included the evaluation of CVD risk factors, diet, exercise habits, and medications. The education phase included discussion of the above risk factors, as well as CVD and thrombosis prevention strategies. Patients were prospectively followed every 3-6 months for risk assessment and continued education by a nurse practitioner and a medical doctor.
Between March 2009 and December 2014, 121 patients were included. At baseline, abnormal blood pressure, blood glucose, cholesterol profile, and body mass index were found in 50 (41%), 7 (6%), 82 (68%), and 77 (64%) patients, respectively. During the 3-year followup, among those with abnormal baseline values, prevalence of abnormal blood pressure significantly decreased (odds ratio [OR] 0.94, 95% confidence interval [95% CI] 0.92-0.96, P < 0.0001) with significant mean ± SD systolic blood pressure improvement (-6.12 ± 2.16 mm Hg; P < 0.05). The prevalence of abnormal cholesterol profile significantly decreased (OR 0.90, 95% CI 0.92-0.96) with significant improvements in mean ± SD high-density lipoprotein (+5.4 ± 0.36 mg/dl; P < 0.0001) and triglyceride levels (-12.6 ± 5.40 mg/dl; P < 0.05), and no significant change in blood glucose and body mass index was observed. At baseline, 100 (83%) and 95 (79%) patients had poor diet and physical activity, respectively; during the followup, both significantly improved in the entire population.
Our data suggest that a CVD prevention counseling program decreases the prevalence of some CVD risk factors in lupus patients.
确定针对狼疮患者的心血管疾病（CVD）预防咨询计划是否会降低 CVD 风险因素的发生率。
该 CVD 预防咨询计划的评估阶段包括评估 CVD 风险因素、饮食、运动习惯和药物。教育阶段包括讨论上述风险因素以及 CVD 和血栓预防策略。患者由一名护士从业者和一名医生每 3-6 个月进行一次前瞻性风险评估和继续教育。
2009 年 3 月至 2014 年 12 月期间，共纳入 121 例患者。基线时，50 例（41%）、7 例（6%）、82 例（68%）和 77 例（64%）患者的血压、血糖、胆固醇谱和体重指数分别异常。在 3 年的随访期间，基线值异常的患者中，血压异常的发生率显著降低（比值比 [OR] 0.94，95%置信区间 [95%CI] 0.92-0.96，P<0.0001），且平均收缩压显著改善（-6.12±2.16mmHg；P<0.05）。胆固醇谱异常的发生率显著降低（OR 0.90，95%CI 0.92-0.96），高密度脂蛋白（+5.4±0.36mg/dl；P<0.0001）和甘油三酯水平（-12.6±5.40mg/dl；P<0.05）显著改善，血糖和体重指数无明显变化。基线时，100 例（83%）和 95 例（79%）患者的饮食和体力活动较差；随访期间，所有患者均显著改善。
我们的数据表明，CVD 预防咨询计划可降低狼疮患者某些 CVD 风险因素的发生率。
