Pima Heart Associates, Tucson, Az; Sarver Heart Center, University of Arizona, Tucson, Az; Foundation for Cardiovascular Health, Tucson, Az.
Foundation for Cardiovascular Health, Tucson, Az.
Am J Med. 2018 Aug;131(8):967-971. doi: 10.1016/j.amjmed.2018.03.029. Epub 2018 Apr 13.
The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population.
Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program.
A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m, P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths).
A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs.
本研究旨在验证以下假设，即基于社区的强化心脏康复方案可使高危人群的风险因素状况和结果产生积极变化。
参与者自愿参加为期 12 周的强化心脏康复计划，以寻求一级或二级冠心病预防。在计划完成后的 6-12 个月内获取基线和数据。
在 2012 年至 2016 年间，共有 142 人（平均年龄 69 岁）完成了心脏系列研究。在 105 名参与者（74%）中可获得随访数据。参与者的平均体重（165 至 162 磅，P=0.0005）、体重指数（26 至 25kg/m，P=0.001）、收缩压（126 至 122mmHg，P=0.01）、舒张压（73 至 70mmHg，P=0.0005）、总胆固醇（175 至 168mg/dL，P=0.03）、低密度脂蛋白胆固醇（LDL-C）（100 至 93mg/dL，P=0.005）、LDL-C/高密度脂蛋白胆固醇（HDL-C）比值（1.8 至 1.6，P=0.005）和胆固醇/HDL-C 比值（3.2 至 3.0，P=0.003）均显示出统计学显著改善。HDL-C、甘油三酯和空腹血糖的变化没有达到统计学意义，但所有这些都朝着有利的方向发展。心血管不良事件很少（1 例支架置入术，无死亡）。
共有 105 名参与者完成了我们的 12 周基于社区的强化心脏康复计划，多项心脏风险指标均显示出显著的积极变化，仅有 1 例不良事件。这些结果与医院和学术机构的方案相比表现良好。
