Sisti L G, Dajko M, Campanella P, Shkurti E, Ricciardi W, de Waure C
Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy.
Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy.
Prev Med. 2018 Apr;109:82-97. doi: 10.1016/j.ypmed.2017.12.027. Epub 2017 Dec 29.
Cardiovascular diseases (CVDs) are the leading cause of premature mortality and disability accounting for one third of all deaths worldwide with considerable impacts on economics and on the quality of life. The evidence suggests that a multifactorial lifestyle intervention might have a role in the CVDs risk reduction, especially in the risk populations, nonetheless the effects on modifiable CVDs risk factors have not been completely explored. Our work aimed at evaluating the impact of multifactorial lifestyle interventions on cardiovascular risk modification, both in the general and risk population. A systematic review and meta-analysis of the randomized controlled trials (RCTs) were performed by including articles published up to April 16th, 2016. RCTs were selected if they had investigated the impact of multifactorial lifestyle interventions on lipids, blood pressure, BMI and waist circumference, smoking and physical activity. Changes in the level of modifiable risk factors from baseline were evaluated. Search resulted in 19,847 studies, of which 36 were included in the analysis. Compared to a usual care, the multifactorial lifestyle intervention is able to lower the blood pressure, total cholesterol, BMI and waist circumference, at both 6 and 12months, and to increase physical activity at 12months. Better results were obtained in primary prevention and in moderate and high risk groups. Multifactorial lifestyle interventions clearly represent a valid tool for reducing the cardiovascular risk factors and should be implemented in the risk groups and in primary prevention.
心血管疾病（CVDs）是过早死亡和残疾的主要原因，占全球所有死亡人数的三分之一，对经济和生活质量产生重大影响。有证据表明，多因素生活方式干预可能在降低心血管疾病风险方面发挥作用，尤其是在高危人群中，尽管如此，对可改变的心血管疾病风险因素的影响尚未得到充分研究。我们的工作旨在评估多因素生活方式干预对一般人群和高危人群心血管风险改善的影响。我们对截至2016年4月16日发表的文章进行了随机对照试验（RCT）的系统评价和荟萃分析。如果随机对照试验研究了多因素生活方式干预对血脂、血压、体重指数（BMI）、腰围、吸烟和身体活动的影响，则将其纳入研究。我们评估了可改变风险因素水平相对于基线的变化。检索结果为19847项研究，其中36项纳入分析。与常规护理相比，多因素生活方式干预在6个月和12个月时均能降低血压、总胆固醇、BMI和腰围，并在12个月时增加身体活动。在一级预防以及中高危组中取得了更好的效果。多因素生活方式干预显然是降低心血管疾病风险因素的有效工具，应在高危人群和一级预防中实施。
