ライフスタイルの介入により,冠動脈疾患のリスクが低下する:PREMIER試験の結果
Nisa M Maruthur1, Nae-Yuh Wang, Lawrence J Appel
1Division of General Internal Medicine and the Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Circulation
|April 8, 2009
まとめ
2つのライフスタイルの介入は,カウンセリングのみと比較して,推定冠動脈疾患 (CHD) のリスクを 12-14%大幅に低下させた. これらの発見は,心血管疾患の危険因子を管理するための公衆衛生上の実質的な利益を示唆しています.
科学分野:
- 心臓病学 心臓病学
- 予防医学は,予防的な医療です.
- 公衆衛生は公衆衛生である.
背景:
- ライフスタイルの介入は,心血管疾患のリスク要因の管理に不可欠です.
- フレミングハムリスク方程式は,冠動脈疾患 (CHD) の10年間のリスクを推定します.
- 推定されたCHDリスクに対する多要素ライフスタイル介入の影響を評価することが重要です.
研究 の 目的:
- CHDの推定リスクに対する2つのライフスタイルの介入の効果と,単独のアドバイスの効果を評価する.
- 基調のサブグループで介入効果が異なっているかどうかを判断する.
主な方法:
- 810人の高血圧前/第1段階の高血圧の成人は,アドバイスのみ,確立されたライフスタイルの推奨,または確立されたDASHダイエットと併せて3つのグループにランダムに分けられました.
- プライマリアウトカム:10年間のCHDリスクは6ヶ月で推定される.
- 二次的なアウトカム:10年間のCHDリスクは,18ヶ月で推定される.
主要な成果:
- 既定および既定プラスDASHグループは,アドバイスのみを受けたグループと比較して,推定CHDリスクの12-14%の減少を示しました.
- 相対リスク比率はそれぞれ0.86と0.88であった (P<0.001).
- 結果は,感受性分析,サブグループ,および18ヶ月で一貫していました.
結論:
- 多要素のライフスタイルの介入は,CHDの推定リスクを大幅に低下させます.
- これらの削減は,心血管疾患の予防のために,公衆衛生上の実質的な利点を提供します.
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