Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care

Abstract

Background. Physical activity, healthful dietary habits, and not smoking are associated with reduced cardiovascular morbidity and mortality. However, few studies have examined how counselling to improve poor lifestyle habits might be carried out in clinical practice. In Swedish primary care, structured lifestyle counselling is still not integrated into everyday clinical practice. The aim of the present study was two-fold: (1) to describe a novel lifestyle intervention programme in primary care; and (2) to evaluate change in unhealthy lifestyle habits over 1 year in men and women with high cardiovascular risk who participated in the lifestyle intervention programme. Method. A single-group study with a 1-year follow-up was carried out. A total of 417 people was enrolled, median age 62 years (54% women), with either hypertension (69%), type 2 diabetes mellitus, or impaired glucose tolerance. The 1-year intervention included five counselling sessions that focused on lifestyle habits, delivered by a district nurse with postgraduate credits in diabetes care and the metabolic syndrome. All patients were offered in-depth counselling for one or more lifestyle habits when needed. Lifestyle habits were assessed by a questionnaire at baseline and 1-year follow-up. Total change was assessed using a nine-factor unhealthy lifestyle habit index. Results. Favourable, significant changes were observed for physical activity, dietary habits, smoking, and stress over 1 year. Similar improvements were seen for both sexes and type of diagnosis. Conclusions. The results support the utility of a multifactorial, structured approach to change unhealthy lifestyle habits for cardiovascular risk prevention in a primary care setting.

Risco cardiovascular em hipertensos cadastrados em uma unidade de saúde no Norte do Brasil

“…Alguns estudos (3,4,9,18,19) evidenciam esses achados, demonstrando que a prevenção da morbidade e mortalidade do sistema cardiovascular implica em abordagem estratificada do hipertenso, com objetivo, metas e ações de prevenção contra o risco de doença arterial coronariana e doenças cardiovasculares, que geralmente são associados a excesso de peso, PAS, triglicerídeos, glicemia em jejum, circunferência da cintura elevada e baixo HDL. As variáveis identificadas dos componentes da SM apresentam uma probabilidade quatro vezes maior de alto escore de risco de doença arterial coronariana (DAC).…”

“It’s up to me”: the experience of patients at high risk of cardiovascular disease of lifestyle change

“…Data were collected from 16 semi-structured, individual interviews of people who participated in a one-year lifestyle programme in a primary care unit in Västerås, Sweden during 2015. The lifestyle programme was delivered by one of four district nurses and have been described in detail earlier in a previous publication [ 10 ]. This study was approved by the local ethics committee at Uppsala (DNR 2014/497/1) and all informants provided informed written consent.…”

“…To improve the care of individuals at high risk of CVD, a structured lifestyle programme was launched at a primary care unit in V€ asterås, Sweden. The programme has previously been described by Lonnberg et al [10]. To improve the effectiveness of lifestyle interventions, it is important to investigate how patients with chronic illness manage lifestyle changes after diagnoses of conditions such as T2DM or hypertension, and thereby prevent future CVD.…”

“…The programme has previously been described by Lonnberg et al. [ 10 ]. To improve the effectiveness of lifestyle interventions, it is important to investigate how patients with chronic illness manage lifestyle changes after diagnoses of conditions such as T2DM or hypertension, and thereby prevent future CVD.…”

Estimation of Cardiovascular Risk Factors & Their Relative Impact in Diabetic Mellitus-2 Adult Patients’ in Mnazi Mmoja Hospital - Zanzibar

“…International guidelines on cardiovascular disease (CVD) prevention include lifestyle counseling to improve unhealthy lifestyle habits to reduce cardiovascular risk. These guidelines emphasize that the highest clinical priority for prevention should be directed towards patients at high cardiovascular risk, such as those with type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) [23,24]. Scientific evaluations of programs to improve lifestyle habits are scarce, despite the knowledge that healthy lifestyle habits are important for reducing cardiovascular risk [25].…”