Effectiveness of programme for reducing cardiovascular risk for men in one general practice.

Gibbins, Roger; Riley, Mollie; Brimble, P

doi:10.1136/bmj.306.6893.1652

Cited by 29 publications

(9 citation statements)

References 7 publications

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“…In the light of recent reports from three community-based prevention trials in the US commented upon in the introduction (2,4,5) as well as from cardiovascular prevention programmes and controlled randomised trials in primary health care (16)(17)(18), we find our results regarding reduced levels of blood pressure, serum cholesterol and serum triglycerides after intervention encouraging. However, one should of course consider the impact of regression towards the mean, as well as concomittant trends in the society, when interpreting the results from our prevention programme.…”

Section: Discussionmentioning

confidence: 56%

Four years experience of a cardiovascular opportunistic screening and prevention programme in the primary health care in Sollentuna, Sweden

Johansson

et al. 1999

Scandinavian Journal of Primary Health Care

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Section: Discussionmentioning

confidence: 56%

Four years experience of a cardiovascular opportunistic screening and prevention programme in the primary health care in Sollentuna, Sweden

Johansson

et al. 1999

Scandinavian Journal of Primary Health Care

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“…From an epidemiological perspective, a sustained 2% drop in population cholesterol concentration should result in a 4% drop in cardiovascular mortality 19. In practice, however, this prediction may be overly optimistic because the reduction in cholesterol concentration achieved by giving dietary advice in primary care was not sustained in a previous trial in Oxfordhshire20 and no reduction was seen at 3-5 years of follow up on audit of 520 health checks for men 21…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of health checks conducted by nurses in primary care: results of the OXCHECK study after one year

Muir

Mant

Jones

et al. 1994

BMJ

168

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Objective : To assess the effectiveness of health checks by nurses in reducing risk factors for cardiovascular disease in patients from general practice. Design : Randomised controlled trial. Setting : Five urban general practices in Bedfordshire. Subjects : 2136 patients receiving an initial health check in 1989-91 and scheduled to be re-examined one year later in 1990-2 (intervention group); 3988 patients receiving an initial health check in 1990-2 (control group). All patients were aged 35-64 years at recruitment in 1989. Main outcome measures : Serum total cholesterol concentration, blood pressure, body mass index, confirmed smoking cessation. Results : Mean serum total cholesterol was 2.3% lower in the intervention group than in the controls (difference 0.14 mmol/l (95% confidence interval 0.08 to 0.20)); the difference was greater in women (3.2%, P<0.0001) than men (1.0%, P=0.18). There was no significant difference in smoking prevalence, quit rates, or body mass index. Systolic and diastolic blood pressure were 2.5% and 2.4% lower respectively in the intervention group. The proportion of patients with diastolic blood pressure >=100 mm Hg was 2.6% (55/2131) in the intervention group and 3.4% (137/3987) in the controls (difference 0.9% (0.0 to 1.7); the proportion with total cholesterol concentration >=8 mmol/l 4.8% (100/2068) and 7.6% (295/3905) (difference 2.7% (1.5 to 4.0)); and that with body mass index >=30 12.4% (264/2125) and 14.0% (559/3984) (difference 1.6% (-0.2 to 3.4)). Conclusion : General health checks by nurses are ineffective in helping smokers to stop smoking, but they help patients to modify their diet and total cholesterol concentration. The public health importance of this dietary change depends on whether it is sustained.

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“…Maybe the results would have been diVerent if the intervention group had consisted only of subjects of high risk. According to a study by Gibbins et al 30 an intervention programme for reducing cardiovascular risk in men was successful only in older patients and those people in whom a specific risk was identified. Another contributory cause could be that many subjects in our investigation worked shifts or had variable working hours which in turn can influence the nutrient supply and the level of stress and consequently also the concentration of cholesterol.…”

Section: Changed Health Habitsmentioning

confidence: 99%

Comparison between two programmes for reducing the levels of risk indicators of heart diseases among male professional drivers.

1998

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Objectives-To compare two programmes for reducing the levels of risk indicators of heart diseases among professional drivers. The programmes were focused on changes of lifestyle. The aim of the programmes was to initiate and motivate a process of change within the driver, which in the long term should lead to permanent and sound health habits. One programme was based on health profile assessment and the other was a health examination. Methods-Altogether, 102 subjects were investigated (51 allocated to an intervention group and 51 to a reference group). The programme in the intervention group (health profile assessment) was based on revelatory communication, adjusted to the driver and contained individual and group activities. The reference group went through a health examination. In both groups blood pressure, serum lipid concentrations, body mass index, and estimated maximal oxygen uptake were measured and the lifestyle habits were surveyed by questionnaires at the start and at follow ups of 6 and 18 months. Results-The results showed that in the intervention group the maximal oxygen uptake increased, as did exercise habits and the intention to practice good dietary habits. Variable working hours was the most common obstacle to change a health habit. In the reference group the maximal oxygen uptake increased and the concentration of serum total cholesterol and the number of people who perceived stress and loneliness decreased. Conclusions-Both the health profile assessment and the health examination had an eVect on the levels of some risk indicators of heart diseases. Both programmes turned out to be useful because of high participation during the entire period and a generally positive attitude among the subjects. (Occup Environ Med 1998;55:554-561) Keywords: intervention study; lifestyle; occupation health service Several investigations have indicated that cardiovascular diseases aVect professional drivers more often than many other occupational groups. This has been independent of research methods, techniques of measurements, and material for comparison. [1][2][3][4][5][6][7] Studies have also shown that drivers are exposed to several possible risk indicators of cardiovascular diseases such as physiological risk indicators (increased blood pressure and total cholesterol concentration) and indicators related to work environment and the lifestyle.Risk indicators related to the work environment were evaluated among 440 male professional drivers in Sweden, 8 and showed that significantly more drivers than referents had a work situation characterised by high demands, low decision latitude, low social support at work, and shift work. It also showed that significantly more drivers than referents were sedentary in their leisure time, smokers, overweight, and consumed a significantly higher proportion of milk fat per day. Low physical activity in leisure time, 2 9 10 high incidence of smokers, [8][9][10] and overweight [8][9][10][11] were also found among professional drivers in other studies. The excess pr...

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Effectiveness of programme for reducing cardiovascular risk for men in one general practice.

Cited by 29 publications

References 7 publications

Four years experience of a cardiovascular opportunistic screening and prevention programme in the primary health care in Sollentuna, Sweden

Four years experience of a cardiovascular opportunistic screening and prevention programme in the primary health care in Sollentuna, Sweden

Effectiveness of health checks conducted by nurses in primary care: results of the OXCHECK study after one year

Comparison between two programmes for reducing the levels of risk indicators of heart diseases among male professional drivers.

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