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联合使用健康生活方式智能手机应用程序和常规初级保健咨询以改善动脉僵硬、血压和波反射:一项随机对照试验(EVIDENT II 研究)。

Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a Randomized Controlled Trial (EVIDENT II Study).

机构信息

Primary Health Care Research Unit, The Alamedilla Health Center, Health Service of Castilla and Leon (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Primary Care Prevention and Health Promotion Research Network (REDIAPP), Salamanca, Spain.

Faculty of Health Sciences, University of Burgos, Burgos, Spain.

出版信息

Hypertens Res. 2019 Jun;42(6):852-862. doi: 10.1038/s41440-018-0182-6. Epub 2018 Dec 26.

Abstract

Our aim was to investigate the effects of an intervention that comprised a brief counseling session on lifestyle habits together with the use of the EVIDENT (Lifestyles and arterial aging) application on the modification of markers that indicated different hemodynamic functions, such as arterial stiffness, blood pressure or wave reflections. The EVIDENT II study (Lifestyles and arterial aging) is a randomized clinical trial with two parallel groups. Each participant had an initial visit and two follow-up visits at 3 and 12 months where the peripheral augmentation index-PAIx75 was measured by tonometry, while an oscillometric method was used for the cardio-ankle vascular index-CAVI and brachial-ankle pulse wave velocity-baPWV. Both groups (intervention-IG and control-CG) were briefly counseled on diet and exercise. The IG also received instructions on the use of the EVIDENT II application during the 3 months. The sample (N = 597; 52 ± 11 years; 64% women) was randomized into IG = 291 and CG = 306. Comparing groups, there was a decrease in the PAIx75 favorable to the IG at 3 months (-4.9%, 95% CI: -7.7 to -2.1) and 12 months (-3.9%, 95% CI: -6.8 to -1.0). There was also a nonsignificant reduction of the CAVI at 3 months in the IG. A group effect was observed in the measurement of the PAIx75 over the 12-month follow-up (p = 0.003). This interaction was only observed in women (p = 0.017). In conclusion, the use of the EVIDENT II application achieved a modification of the PAIx75, a marker of wave reflection and vascular tone, in women through lifestyle improvements (physical activity and adherence to the Mediterranean diet). No significant results were found regarding blood pressure or arterial stiffness markers.

摘要

我们的目的是研究一项干预措施的效果,该干预措施包括一次简短的生活方式习惯咨询,以及使用 EVIDENT(生活方式和动脉老化)应用程序来改变指示不同血液动力学功能的标志物,如动脉僵硬、血压或波反射。EVIDENT II 研究(生活方式和动脉老化)是一项随机临床试验,分为两个平行组。每个参与者有一次初始就诊和两次随访就诊,在 3 个月和 12 个月时通过容积描记法测量外周动脉增强指数-PAIx75,而使用振荡法测量心踝血管指数-CAVI 和肱踝脉搏波速度-baPWV。两组(干预组-IG 和对照组-CG)均接受了关于饮食和运动的简短咨询。IG 还在 3 个月内接受了关于使用 EVIDENT II 应用程序的指导。样本(N=597;52±11 岁;64%为女性)随机分为 IG=291 和 CG=306。比较两组,IG 在 3 个月和 12 个月时 PAIx75 降低,有利于 IG(-4.9%,95%CI:-7.7 至-2.1)和 12 个月(-3.9%,95%CI:-6.8 至-1.0)。IG 组在 3 个月时 CAVI 也有轻微降低。在 12 个月的随访中观察到 PAIx75 的组间差异(p=0.003)。这种交互作用仅在女性中观察到(p=0.017)。结论:通过改善生活方式(身体活动和遵循地中海饮食),EVIDENT II 应用程序的使用实现了女性 PAIx75(波反射和血管张力标志物)的改变,而血压或动脉僵硬标志物没有明显变化。

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