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Effect on cardiovascular risk of an intervention by family physicians to promote physical exercise among sedentary individuals |
Garcia-Ortiz L, Grandes G, Sanchez-Perez A, Montoya I, Iglesias-Valiente JA, Recio-Rodriguez JI, Castano-Sanchez Y, Gomez-Marcos MA, PEPAF group |
Revista Espanola de Cardiologia 2010 Nov;63(11):1244-1252 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
INTRODUCTION AND OBJECTIVES: To evaluate the effect of a program promoting physical activity (PEPAF) implemented by family physicians on cardiovascular risk reduction. METHODS: The cluster randomized clinical trial involved 56 family physicians randomly allocated to an intervention group (n = 29) and a control group (n = 27). Of the patients recruited, only those aged 30 to 74 years (1,915 PEPAF and 1,783 control) were included in the analysis. The intervention involved giving general advice about the benefits of physical activity to all patients and prescribed advice to a subgroup of patients (30%) who agreed to an additional consultation. Outcome measures included risk factors and cardiovascular risk assessed using the Framingham-D'Agostino scale. RESULTS: A significant decrease from baseline in systolic and diastolic blood pressure and pulse pressure was observed after 12 months in both groups (control group -2.93 mmHg, -1.81 mmHg and -1.15 mmHg, respectively; PEPAF group -3.35 mmHg, -1.4 mmHg, and -1.94 mmHg, respectively). The high-density lipoprotein cholesterol level increased (control group: +1.73 mg/dl; PEPAF group: +2.67 mg/dl), while the atherogenic index decreased (by 0.12 and 0.16 in the two groups, respectively), all from baseline (p < 0.05). Cardiovascular risk decreased by 0.68 (95% confidence interval (CI) 0.13 to 1.25) in the control group and 0.79 (95%CI 0.22 to 1.35) in the PEPAF group. There was no significant difference in the improvement at 12 months between the groups. CONCLUSIONS: Patients' participation in the project was effective in improving control of risk factors and decreasing cardiovascular risk. No significant difference in outcome was observed between the control group and the group participating in the program promoting physical activity.
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