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一项体育活动计划对成年初级卫生保健使用者心血管疾病风险的有效性:“一步一步来”社区干预试验。

Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: the "Pas-a-Pas" community intervention trial.

作者信息

Arija Victoria, Villalobos Felipe, Pedret Roser, Vinuesa Angels, Timón Mercé, Basora Teresa, Aguas Dolors, Basora Josep

机构信息

Unit of Research Support Reus-Tarragona, Institut d'Investigació en Atenció Primária, IDIAP Jordi Gol, Barcelona, Spain.

Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain.

出版信息

BMC Public Health. 2017 Jun 15;17(1):576. doi: 10.1186/s12889-017-4485-3.

Abstract

BACKGROUND

Physical activity is a major, modifiable, risk factor for cardiovascular disease (CVD) that contributes to the prevention and management of CVD. The aim of this study was to assess the short- and medium-term effectiveness of 9 months of a supervised physical activity program, including sociocultural activities, on CVD risk in adults.

METHODS

Multicentered, randomized, controlled community intervention involving 364 patients in four primary care centers. The participants were randomly assigned to a Control Group (CG = 104) or Intervention Group (IG = 260); mean age 65.19 years; 76.8% women. The intervention consisted of 120 min/week walking (396 METs/min/week) and sociocultural gathering once a month. Clinical history, physical activity, dietary intake, CVD risk factors (smoking, systolic and diastolic blood pressure, weight, waist circumference, BMI, total cholesterol, LDL- and HDL-cholesterol, triglycerides, glycosylated hemoglobin and glucose) and global CVD risk were assessed at baseline and at the end of the intervention and multivariate models were applied to the data. Incidence of adverse cardiovascular events and continued adherence to the physical activity were assessed 2 years after intervention.

RESULTS

At the end of the intervention period, in the IG relative to the CG group, there was a significant increase in physical activity (774.81 METs/min/week), a significant change during the intervention period in systolic blood pressure (-6.63 mmHg), total cholesterol (-10.12 mg/dL) and LDL-cholesterol (-9.05 mg/dL) even after adjustment for potential confounders. At 2 years after the intervention, in the IG, compared with the CG, tthe incidence of adverse cardiovascular events was significantly lower (2.5% vs. 10.5%) and the adherence to regular physical activity was higher (72.8% vs 27.2%) in IG compared to CG.

CONCLUSIONS

This community-based physical activity program improved cardiovascular health in the short- as well as medium-term, and promoted regular physical activity in the medium-term in older Spanish adults.

TRIALS REGISTRATION

Clinicaltrials.gov ID NCT02767739 . Trial registered on May 5th, 2016. Retrospectively registered.

摘要

背景

身体活动是心血管疾病(CVD)的一个主要、可改变的风险因素,有助于预防和管理心血管疾病。本研究的目的是评估一项为期9个月的有监督的身体活动计划(包括社会文化活动)对成年人心血管疾病风险的短期和中期效果。

方法

多中心、随机、对照社区干预,涉及四个初级保健中心的364名患者。参与者被随机分配到对照组(CG = 104)或干预组(IG = 260);平均年龄65.19岁;76.8%为女性。干预包括每周120分钟步行(396 METs/分钟/周)和每月一次社会文化聚会。在基线、干预结束时评估临床病史、身体活动、饮食摄入、心血管疾病风险因素(吸烟、收缩压和舒张压、体重、腰围、BMI、总胆固醇、低密度脂蛋白和高密度脂蛋白胆固醇、甘油三酯、糖化血红蛋白和血糖)以及总体心血管疾病风险,并对数据应用多变量模型。干预2年后评估不良心血管事件的发生率和对身体活动的持续依从性。

结果

在干预期结束时,与CG组相比,IG组的身体活动显著增加(774.81 METs/分钟/周),即使在调整潜在混杂因素后,干预期间收缩压(-6.63 mmHg)、总胆固醇(-10.12 mg/dL)和低密度脂蛋白胆固醇(-9.05 mg/dL)也有显著变化。干预2年后,与CG组相比,IG组不良心血管事件的发生率显著更低(2.5%对10.5%),且IG组对定期身体活动的依从性更高(72.8%对27.2%)。

结论

这项基于社区的身体活动计划在短期和中期改善了西班牙老年成年人的心血管健康,并在中期促进了他们的定期身体活动。

试验注册

Clinicaltrials.gov标识符NCT02767739。于2016年5月5日注册。回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc1/5471891/5c01af952d51/12889_2017_4485_Fig1_HTML.jpg

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