一项健康对话干预措施可降低心血管危险因素水平：一项在瑞典初级保健机构开展的、为期1年随访的基于人群的随机对照试验。

A health dialogue intervention reduces cardiovascular risk factor levels: a population based randomised controlled trial in Swedish primary care setting with 1-year follow-up.

作者信息

Hellstrand Mats, Simonsson Bo, Engström Sevek, Nilsson Kent W, Molarius Anu

机构信息

Competence Centre for Health, Region Västmanland, 721 89, Västerås, Sweden.

Centre for Clinical Research, Region Västmanland /University of Uppsala, Uppsala, Sweden.

出版信息

BMC Public Health. 2017 Aug 22;17(1):669. doi: 10.1186/s12889-017-4670-4.

DOI:10.1186/s12889-017-4670-4

PMID:28830474

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5568359/

Abstract

BACKGROUND

The total number of cardiovascular (CVD) deaths accounted for almost a third of all deaths globally in 2013. Population based randomised controlled trials, managed within primary care, on CVD risk factor interventions are scarce. The aim of the study was to evaluate the effects of a health dialogue intervention in a primary care setting offered to a population at the age of 55 years, focusing on CVD risk factors.

METHODS

The study was performed in five primary health care centres in the county of Västmanland, Sweden between April 2011 and December 2012. Men and women were randomly assigned to intervention (n = 440) and control groups (n = 440). At baseline, both groups filled in a health questionnaire and serum cholesterol, fasting plasma glucose, glycated haemoglobin (HbA1c), weight, height, waist (WC) and hip circumference, waist hip ratio (WHR) and systolic/diastolic blood pressure were measured. Intervention group attended a health dialogue, supported by a visualised health profile, with a possibility for further activities. Participation rates at baseline were 53% and 52% respectively. A 1-year follow-up was carried out.

RESULTS

The intervention group (n = 165) showed reductions compared to the control group (n = 177) concerning body mass index (BMI) (0.3 kg/m, p = .031), WC (2.1 cm, p ≤ .001) and WHR (.002, p ≤ .001) at the 1-year follow-up. No differences between the intervention and control groups were found in other variables. Intervention group, compared to baseline, had reduced weight, BMI, WC, WHR, HbA1c, and diet, while the men in the control group had reduced their alcohol consumption.

CONCLUSIONS

A health dialogue intervention at the age of 55 years, conducted in ordinary primary care, showed a moderate effect on CVD risk factor levels, in terms of BMI, WC and WHR.

TRIAL REGISTRATION NUMBER

BioMed Central, ISRCTN22586871 , date assigned; 10/12/2015.

摘要

背景

2013年，心血管疾病（CVD）死亡总数几乎占全球总死亡人数的三分之一。在初级保健机构中开展的基于人群的心血管疾病危险因素干预随机对照试验很少。本研究的目的是评估在初级保健环境中对55岁人群实施的健康对话干预措施对心血管疾病危险因素的影响。

方法

2011年4月至2012年12月期间，在瑞典韦斯特曼兰县的五个初级卫生保健中心进行了这项研究。男性和女性被随机分为干预组（n = 440）和对照组（n = 440）。在基线时，两组都填写了一份健康问卷，并测量了血清胆固醇、空腹血糖、糖化血红蛋白（HbA1c）、体重、身高、腰围（WC）、臀围、腰臀比（WHR）以及收缩压/舒张压。干预组参加了一次由可视化健康档案支持的健康对话，并有机会参加进一步的活动。基线时的参与率分别为53%和52%。进行了为期1年的随访。

结果

在1年随访时，干预组（n = 165）与对照组（n = 177）相比，体重指数（BMI）（降低0.3kg/m²，p = 0.031）、腰围（WC）（降低2.1cm，p≤0.001）和腰臀比（降低0.002，p≤0.001）有所下降。干预组和对照组在其他变量上未发现差异。与基线相比，干预组的体重、BMI、WC、WHR、HbA1c和饮食有所改善，而对照组的男性饮酒量有所减少。