五年预测心血管健康的健康和健康辅导:一个随机对照试验
Rita V Krishnamurthi1, Alain C Vandal1, Suzanne Barker-Collo1
1National Institute for Stroke and Applied Neurosciences (RVK, SM, ER, VLF), School of Clinical Sciences, Auckland University of Technology; Department of Statistics (ACV), The University of Auckland; Ko Awatea, Counties Manukau Health; Department of Psychology (SB-C); Department of Neurology (PAB); Department of General Practice (BA), The University of Auckland; and Te Whare Wānanga o Awanuiārangi (HE), Auckland, New Zealand.
Neurology. Clinical practice
|January 10, 2024
概括
健康和健康指导 (HWC) 在高风险人群中显著降低了心血管疾病 (CVD) 风险,但在中等风险人群中没有降低. HWC显示了改善中风预防生活方式风险因素的潜力.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 卫生教练健康教练
背景情况:
- 在初级中风预防中,多因素生活方式干预的证据有限.
- 生活方式对整体中风负担有很大影响.
- 健康和健康指导 (HWC) 被探索为一种潜在的干预措施.
研究的目的:
- 确定HWC对初级中风和心血管疾病 (CVD) 预防的疗效.
- 评估中度至高心血管疾病风险的成年人中的HWC.
- 评估HWC对5年心血管疾病风险和Life's Simple 7 (LS7) 评分的影响.
主要方法:
- 第三阶段,并行,双臂,开放标签,单盲随机受控试验.
- 320名5年心血管疾病风险≥10%的参与者 (≥30岁) 被随机分配到HWC或通常护理 (UC).
- 主要结局:9个月5年心血管疾病风险;次要结局:LS7得分.
主要成果:
- 在高风险组的5年心血管疾病风险中,HWC实现了统计学上显著的10.9%的相对风险降低 (RRR) (基线风险≥15%).
- 在中度风险组 (10%-14%),心血管疾病风险没有显著变化.
- 与UC相比,HWC组的总LS7得分 (绝对差异=0.485) 和血压得分有所改善,特别是在高风险小组中.
结论:
- 在高风险人群中,HWC证明了5年内心血管疾病风险的临床显著降低.
- 该研究没有满足其主要假设,因为在中等风险组缺乏效果.
- HWC显示了改进生活方式干预措施以减轻中风风险因素的前景.
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