BACKGROUND: Most studies that have analysed the effect of secondary prevention of coronary heart disease come from hospitals. Those that are community-based have been conducted mainly by nurses and follow-up was generally too short to show impact on cardiovascular events. METHODS: This is a multi-centre randomised controlled clinical trial in which patients in the intervention group received periodic postal reminders to see their general practitioner every three months during a 3-year follow-up. General practitioners reinforced healthy lifestyle recommendations to patients and reviewed drug therapies at these quarterly intervals. Patients in the control group received usual care. RESULTS: A total of 983 patients aged 30-79 were included. During the 3-year follow-up, 67 patients died and 156 experienced a non-fatal cardiovascular event. The event rates and all-cause mortality were similar in the intervention and control groups (24.0% and 23.5%, and 8.1% and 9.9%, respectively). Improvement in quality of life was similar in both groups. Blood pressure and high-density lipoprotein cholesterol were more frequently within recommended levels in the intervention group than in controls: odds ratio 1.63, 95% confidence interval 1.05-2.51, and odds ratio 2.61, 95% confidence interval 1.32-5.18, respectively. CONCLUSIONS: Intensive secondary prevention conducted by general practitioners may improve long-term blood pressure control and increase high-density lipoprotein cholesterol in patients with stable coronary disease.
RCT Entities:
BACKGROUND: Most studies that have analysed the effect of secondary prevention of coronary heart disease come from hospitals. Those that are community-based have been conducted mainly by nurses and follow-up was generally too short to show impact on cardiovascular events. METHODS: This is a multi-centre randomised controlled clinical trial in which patients in the intervention group received periodic postal reminders to see their general practitioner every three months during a 3-year follow-up. General practitioners reinforced healthy lifestyle recommendations to patients and reviewed drug therapies at these quarterly intervals. Patients in the control group received usual care. RESULTS: A total of 983 patients aged 30-79 were included. During the 3-year follow-up, 67 patients died and 156 experienced a non-fatal cardiovascular event. The event rates and all-cause mortality were similar in the intervention and control groups (24.0% and 23.5%, and 8.1% and 9.9%, respectively). Improvement in quality of life was similar in both groups. Blood pressure and high-density lipoprotein cholesterol were more frequently within recommended levels in the intervention group than in controls: odds ratio 1.63, 95% confidence interval 1.05-2.51, and odds ratio 2.61, 95% confidence interval 1.32-5.18, respectively. CONCLUSIONS: Intensive secondary prevention conducted by general practitioners may improve long-term blood pressure control and increase high-density lipoprotein cholesterol in patients with stable coronary disease.
Authors: Edel Murphy; Akke Vellinga; Molly Byrne; Margaret E Cupples; Andrew W Murphy; Brian Buckley; Susan M Smith Journal: Br J Gen Pract Date: 2015-07 Impact factor: 5.386
Authors: Domingo Orozco-Beltran; Esther Ruescas-Escolano; Ana Isabel Navarro-Palazón; Alberto Cordero; María Gaubert-Tortosa; Jorge Navarro-Perez; Concepción Carratalá-Munuera; Salvador Pertusa-Martínez; Enrique Soler-Bahilo; Francisco Brotons-Muntó; Jose Bort-Cubero; Miguel Angel Nuñez-Martinez; Vicente Bertomeu-Martinez; Vicente Francisco Gil-Guillen Journal: BMC Health Serv Res Date: 2013-08-02 Impact factor: 2.655
Authors: J S Benner; L Erhardt; M Flammer; R A Moller; N Rajicic; K Changela; C Yunis; S B Cherry; Z Gaciong; E S Johnson; M C J M Sturkenboom; J García-Puig; X Girerd Journal: Int J Clin Pract Date: 2008-08-07 Impact factor: 2.503
Authors: A W Murphy; M E Cupples; E Murphy; J Newell; C J Scarrott; A Vellinga; P Gillespie; M Byrne; C Kearney; S M Smith Journal: BMJ Open Date: 2015-11-03 Impact factor: 2.692