Wolska Magdalena, Uchmanowicz Izabella, Zelek Leszek, Jankowski Piotr, Sławska Agnieszka, Sowa Łukasz, Piotrowska Aleksandra, Sielski Janusz, Kaziród-Wolski Karol, Malinowski Krzysztof P, Siudak Zbigniew
Outpatient Treatment Facility "CenterMed," Kielce, Poland.
Department of Clinical Nursing, Wroclaw Medical University, Wrocław, Poland.
Kardiol Pol. 2024;82(11):1109-1118. doi: 10.33963/v.phj.103133.
Body mass index (BMI) reduction in secondary prevention of cardiovascular diseases requires a multidimensional intervention.
We aimed to evaluate the effect of regular 1-year nursing supervision on weight reduction in secondary prevention in patients with acute coronary syndromes.
The study was conducted from 2018 to 2022. Seven thousand six hundred twelve patients were enrolled within 12 months after acute coronary syndrome, and regular nursing counseling was conducted every 2 months.
A 5% reduction in BMI was achieved by 6812 (89.75%) patients. BMI of the entire population decreased (27.47[0.08] vs. 27.19 [0.08]; P <0.001). The BMI reduction was achieved in all patients regardless of their sex, smoking status, and level of education measured by the International Standard Classification of Education (ISCED) as well as in the subgroup with the highest stress level, 26.95(0.2) vs. 27.11 (0.06); P = 0.03, and the lowest physical activity level 27.63 (0.06) vs. 27.31 (0.06); P = 0.01. Linear regression showed that active smoking status (β -0.77; 95% confidence interval [CI], -0.95 to -0.59; P <0.001), ISCED 5-8 (β -0.43; 95% CI, -0.82 to -0.03; P = 0.03), ISCED 2 (β 0.79; 95% CI, 0.05-1.53; P = 0.04), ISCED 3 (β 0.55; 95% CI, 0.16-0.93; P = 0.01), the level of triglycerides (β 0.78; 95% CI, 0.61-0.95; P <0.001), and the waist-hip ratio (β 0.74; 95% CI, 0.68-0.80; P <0.001) were the strongest predictors of BMI change.
After 1 year and 6 follow-up visits, the average BMI of the entire population decreased significantly. BMI decreased in men and women, smokers and non-smokers, in patients with all levels of education, and in the subgroups with high stress and low physical activity. The strongest predictors of BMI reduction were high educational status and active smoking status.
在心血管疾病二级预防中降低体重指数(BMI)需要进行多维度干预。
我们旨在评估为期1年的定期护理监督对急性冠状动脉综合征患者二级预防中体重减轻的影响。
该研究于2018年至2022年进行。7612例患者在急性冠状动脉综合征后12个月内入组,每2个月进行一次定期护理咨询。
6812例(89.75%)患者的BMI降低了5%。总体人群的BMI下降(27.47[0.08]对27.19[0.08];P<0.001)。无论患者的性别、吸烟状况以及根据国际教育标准分类(ISCED)衡量的教育水平如何,所有患者的BMI均有所降低,在压力水平最高的亚组中也是如此,26.95(0.2)对27.11(0.06);P = 0.03,以及身体活动水平最低的亚组中也是如此,27.63(0.06)对27.31(0.06);P = 0.01。线性回归显示,当前吸烟状况(β -0.77;95%置信区间[CI],-0.95至-0.59;P<0.001)、ISCED 5-8(β -0.43;95%CI,-0.82至-0.03;P = 0.03)、ISCED 2(β 0.79;95%CI,0.05-1.53;P = 0.04)、ISCED 3(β 0.55;95%CI,0.16-0.93;P = 0.01)、甘油三酯水平(β 0.78;95%CI,0.61-0.95;P<0.001)以及腰臀比(β 0.74;95%CI,0.68-0.80;P<0.0