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Published on: February 8, 2019
[Life-habit intervention in a public institution]
Carlos Scherr1, Ademir Batista da Cunha, Chyntia Karla Magalhães
1Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brasil. cscherr@cardiol.br
Insights
This study shows that a multiprofessional public health program effectively reduced atherosclerosis risk factors. Patients improved diet, increased physical activity, and reduced smoking, demonstrating the program's success in promoting healthier lifestyles.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Coronary heart disease is a leading global cause of death, with significant mortality and morbidity following acute myocardial infarction (AMI).
- Secondary prevention strategies are crucial for managing patients with established coronary artery disease.
- High rates of recurrent AMI and sudden death underscore the need for effective interventions.
Purpose of the Study:
- To evaluate the efficacy of a multidisciplinary intervention program aimed at modifying atherosclerosis risk factors within a public health system.
- To assess the impact of the program on patient lifestyle behaviors and clinical markers.
Main Methods:
- A cohort of 513 patients with coronary artery disease, selected from 2,337 outpatients, participated in the study.
- The intervention involved educational lectures focused on risk factor control.
- Statistical analyses included paired t-tests, Wilcoxon's test, independent samples t-tests, Mann-Whitney test, ANOVA, and Kruskal-Wallis tests for pre- and post-intervention comparisons.
Main Results:
- Significant reductions were observed in cholesterol, LDL, triglycerides, body mass index, Castelli indexes I and II, and waist circumference.
- Dietary adherence improved, with 72% of non-adherent patients adopting a healthier diet.
- Physical activity increased, with 71% of previously sedentary patients exercising regularly, and smoking cessation/reduction was noted in 60% of smokers.
Conclusions:
- The multiprofessional program proved effective in improving lifestyle habits among patients within the public health system.
- These findings support the implementation of similar programs for secondary prevention of coronary artery disease.
- The study highlights the successful application of public health system resources for cardiovascular risk management.
Background:
Coronary disease is the major worldwide cause of death, according to the World Health Organization (WHO) and the second in Brazil. Sudden death occurs 4 to 6 times more frequently in those who have suffered an acute myocardial infarction (AMI); within 6 years, 18% of the men and 35% of the women will have a new AMI. The secondary prevention, of which effectiveness has been previously demonstrated, is of utmost importance.
Objective:
To test the effectiveness of a multiprofessional program that aims at modifying risk factors for atherosclerosis in the public health system.
Methods:
Of the 2,337 patients with coronary artery disease undergoing outpatient treatment, 513 with a coronary angiography study agreed to participate in the present study, which used lectures on how and why to control risk factors as therapeutic tool.
Statistical Analysis:
significant variation pre and post-intervention; paired Student's t test or Wilcoxon's test ; existence of a significant difference between the two groups; Student's t test for independent samples or Mann-Whitney test. Comparison among three groups: analysis of variance (ANOVA) or Kruskal-Wallis.
Results:
Cholesterol, LDL, triglycerides, body mass index, Castelli indexes I and II and waist circumference showed a significant decrease, even in patients without hypolipemiant treatment. The assessment of the diet impact showed that 72% of the patients that did not follow a diet, started to do so. Physical activity: of the 55% sedentary patients, 71% started to exercise three or more times a week. Smoking: of the smokers, 60% (9% of the total) stopped smoking and 32% decreased the number of cigarettes.
Conclusion:
These results demonstrated the effectiveness of the programs to improve life habits when applied to the units of the public health system. (Arq Bras Cardiol. 2010; [online]. ahead print, PP.0-0).
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