INTRODUCTION AND OBJECTIVES: To assess the efficacy of a comprehensive program of secondary prevention of cardiovascular disease in general practice. METHODS: A cluster randomized clinical trial was carried out in a regular general practice setting. Male and female patients aged under 86 years with a diagnosis of ischemic heart disease, stroke or peripheral artery disease were recruited between January 2004 and May 2005. Study participants were seen at 42 health centers throughout the whole of Spain. The primary endpoint was the combination of all-cause mortality and hospital cardiovascular readmission at 3-year follow-up. RESULTS: In total, 1224 patients were recruited: 624 in the intervention group and 600 in the control group. The primary endpoint was observed in 29.9% (95% confidence interval [CI], 25.5-34.8%) in the intervention group and 25.6% (22.3-29.2%) in the control group (P=.15). At the end of follow-up, 8.5% (6.3-11.3%) in the intervention group and 11% (7.4-16%) in the control group were smokers (P=.07). The mean waist circumference of patients in the intervention and control groups was 100.44 cm (95% CI, 98.97-101.91 cm) and 102.58 cm (95% CI, 100.96-104.21 cm), respectively (P=.07). Overall, 20.9% (15.6-27.7%) of patients in the intervention group and 29.6% (23.9-36.1%) in the control group suffered from anxiety (P=.05), and 29.6% (22.4-37.9%) in the intervention group and 41.4% (35.8-47.3%) in the control group had depression (P=.02). CONCLUSIONS: A comprehensive program of secondary prevention of cardiovascular disease in general practice was not effective in reducing cardiovascular morbidity and mortality. However, some factors associated with a healthy lifestyle were improved and anxiety and depression were reduced.
RCT Entities:
INTRODUCTION AND OBJECTIVES: To assess the efficacy of a comprehensive program of secondary prevention of cardiovascular disease in general practice. METHODS: A cluster randomized clinical trial was carried out in a regular general practice setting. Male and female patients aged under 86 years with a diagnosis of ischemic heart disease, stroke or peripheral artery disease were recruited between January 2004 and May 2005. Study participants were seen at 42 health centers throughout the whole of Spain. The primary endpoint was the combination of all-cause mortality and hospital cardiovascular readmission at 3-year follow-up. RESULTS: In total, 1224 patients were recruited: 624 in the intervention group and 600 in the control group. The primary endpoint was observed in 29.9% (95% confidence interval [CI], 25.5-34.8%) in the intervention group and 25.6% (22.3-29.2%) in the control group (P=.15). At the end of follow-up, 8.5% (6.3-11.3%) in the intervention group and 11% (7.4-16%) in the control group were smokers (P=.07). The mean waist circumference of patients in the intervention and control groups was 100.44 cm (95% CI, 98.97-101.91 cm) and 102.58 cm (95% CI, 100.96-104.21 cm), respectively (P=.07). Overall, 20.9% (15.6-27.7%) of patients in the intervention group and 29.6% (23.9-36.1%) in the control group suffered from anxiety (P=.05), and 29.6% (22.4-37.9%) in the intervention group and 41.4% (35.8-47.3%) in the control group had depression (P=.02). CONCLUSIONS: A comprehensive program of secondary prevention of cardiovascular disease in general practice was not effective in reducing cardiovascular morbidity and mortality. However, some factors associated with a healthy lifestyle were improved and anxiety and depression were reduced.
Authors: Christopher M Celano; Rachel A Millstein; C Andres Bedoya; Brian C Healy; Annelieke M Roest; Jeff C Huffman Journal: Am Heart J Date: 2015-09-21 Impact factor: 4.749
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Authors: Anne Forster; Lesley Brown; Jane Smith; Allan House; Peter Knapp; John J Wright; John Young Journal: Cochrane Database Syst Rev Date: 2012-11-14
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: Josep Maria Pepió Vilaubí; Domingo Orozco-Beltrán; Alessandra Queiroga Gonçalves; Dolors Rodriguez Cumplido; Carina Aguilar Martin; Adriana Lopez-Pineda; Vicente F Gil-Guillen; Jose A Quesada; Concepcion Carratala-Munuera Journal: Int J Environ Res Public Health Date: 2018-06-11 Impact factor: 3.390