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[强化干预对高纤维蛋白原血症及中度-高度心血管风险患者生活方式改变的长期影响]

[Long-term effects of intensive intervention on changes in lifestyle in patients with hyperfibrinogenaemia and moderate-high cardiovascular risk].

作者信息

Illamola Martin Laura, Rodríguez Cristobal Juan José, Alonso-Villaverde Carlos, Salvador-González Betlem, Moral Pelaez Irene

机构信息

CAP Roger de Flor, EAP Dreta de l'Eixample, Barcelona, España.

CAP Florida Sud, Institut Català de la Salut (ICS), L'Hospitalet de Llobregat, Barcelona, España.

出版信息

Aten Primaria. 2018 Jun-Jul;50(6):325-331. doi: 10.1016/j.aprim.2017.04.004. Epub 2017 Jul 18.

Abstract

OBJECTIVES

To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk.

DESIGN

multicentre prospective observational study.

LOCATION

13 Primary Care Centres in Barcelona and Baix Llobregat.

PARTICIPANTS

A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group).

INTERVENTIONS

The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years.

MAIN MEASUREMENTS

Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR.

RESULTS

At 5 years, the intervention group had a lower abdominal circumference (98 and 101cm, respectively, P=.043), a lower weight (76.30 and 75.04kg, respectively, P<.001), and BMI (29.5 and 30.97kg/m, P=.018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P < .001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P < .06).

CONCLUSION

The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS.

摘要

目的

确定在持续2年的强化生活方式干预后5年,这种干预对患有高纤维蛋白原血症且心血管风险为中度或高度的患者的心血管危险因素(CVRF)的益处是否依然存在。

设计

多中心前瞻性观察研究。

地点

巴塞罗那和baix Llobregat的13个初级保健中心。

参与者

共有300名完成EFAP研究的患者(146名干预组,154名对照组)。

干预措施

对胆固醇正常但纤维蛋白原升高的患者进行的EFAP研究表明,生活方式干预在降低CVRF方面是有效的。EFAP研究结束后,两组接受常规对照,并在5年后重新评估。

主要测量指标

年龄、性别、心血管疾病(CVD)(糖尿病、血脂异常、高血压、肥胖)、实验室参数(纤维蛋白原、葡萄糖、全血细胞计数、胆固醇、甘油三酯)、血压、体重、身高、体重指数(BMI)、烟草和酒精使用情况、REGICOR。

结果

在5年时,干预组的腹围较低(分别为98和101厘米,P = 0.043),体重较低(分别为76.30和75.04千克,P < 0.001),BMI较低(29.5和30.97千克/米,P = 0.018)。干预组的纤维蛋白原水平较低(分别为330.33和320.27毫克/分升,P < 0.001),干预组的REGICOR风险也较低(分别为5.65和5.59,P < 0.06)。

结论

强化生活方式干预2年对降低CVRF的益处持续到5年,但随着时间推移其强度会降低。建议定期重复干预措施以维持对生活方式的有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1da6/6836964/8732e8ab27f7/fx1.jpg

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