Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O K, Fagerberg B
Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden.
J Intern Med. 1994 Dec;236(6):651-9. doi: 10.1111/j.1365-2796.1994.tb00858.x.
To examine the feasibility and efficacy of a multifactorial intervention programme directed towards hypercholesterolaemia, smoking, and diabetes mellitus in treated hypertensive patients after more than 3 years' follow-up and to describe the incidence of cardiovascular complications.
Open, randomized, parallel-group study with allocation either to a comprehensive multiple risk factor modification programme or to usual care.
Outpatient clinic in a city hospital.
A total of 508 male patients with treated hypertension, aged 50-72 years, with at least one of the following: serum cholesterol > or = 6.5 mmol L-1, smoking or diabetes mellitus.
Individually given advice and group meetings based on nutritional advice and behavioral treatment principles. Drug therapy could be instituted to achieve the treatment goals in the intervention group: serum total cholesterol below 6.0 mmol L-1, no smoking, and HbA1c below 6.0%. Diastolic blood pressure below 90 mmHg was the treatment goal in both groups.
Serum cholesterol, HbA1c, diastolic blood pressure, smoking. Cardiovascular end-points were recorded.
The net changes were (change intervention--change usual care): serum cholesterol -5.0% (95% confidence interval, -7.6 to -2.3%), 17.6% more stopped smoking (P = 0.04); diastolic blood pressure and HbA1c remained unchanged. The incidence of stroke was lower in the intervention group compared with the usual-care group: 2.0 and 6.7%, respectively (P = 0.017).
The intervention programme was comparatively successful with regards to the effects on hypercholesterolaemia and smoking habits. An unexpected decrease in the stroke incidence was observed in the intervention group compared with the usual-care group.
在对接受治疗的高血压患者进行3年以上随访后，研究针对高胆固醇血症、吸烟和糖尿病的多因素干预方案的可行性和疗效，并描述心血管并发症的发生率。
开放、随机、平行组研究，分为综合多危险因素修正方案组或常规治疗组。
城市医院门诊。
共508例接受治疗的男性高血压患者，年龄50 - 72岁，至少具有以下情况之一：血清胆固醇≥6.5 mmol/L、吸烟或糖尿病。
根据营养建议和行为治疗原则提供个体化建议并组织小组会议。干预组可采用药物治疗以实现治疗目标：血清总胆固醇低于6.0 mmol/L、戒烟、糖化血红蛋白低于6.0%。两组的舒张压治疗目标均为低于90 mmHg。
血清胆固醇、糖化血红蛋白、舒张压、吸烟情况。记录心血管终点事件。
净变化为（干预组变化 - 常规治疗组变化）：血清胆固醇 -5.0%（95%置信区间，-7.6至 -2.3%），戒烟者多17.6%（P = 0.04）；舒张压和糖化血红蛋白无变化。干预组的中风发生率低于常规治疗组：分别为2.0%和6.7%（P = 0.017）。
该干预方案在对高胆固醇血症和吸烟习惯的影响方面相对成功。与常规治疗组相比，干预组的中风发生率意外降低。
