Randomized trial of cardiovascular prevention in Norway combining an in-hospital lifestyle course with primary care follow-up: the Hjerteløftet study

Bergum, Hilde; Sandven, Irene; Abdelnoor, Michael; Anderssen, Sigmund Alfred; Grimsmo, Jostein; Rivrud, Dag Elle; Myhr, Nils Erling; Vold, Mona Bekken; Stenbakken, Cesilie; Lidfors, Bengt; Dufseth, Laila; Klemsdal, Tor Ole

doi:10.1093/eurjpc/zwac211

Cited by 6 publications

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“…A major finding in the present substudy of a primary prevention trial [ 2 ], was a statistically significant increased PA level in favour of the IG. The program also resulted in a within group significant decrease in the proportion of patients reporting being inactive in the IG, while the decrease was less prominent in the CG.…”

Section: Discussionmentioning

confidence: 71%

“…As described in detail previously [ 2 ], patients in the Hjerteløftet Study were referred for participation from general practitioners (GP) in Norway and could be included if 35—67 years of age and had elevated CVD risk. Elevated risk was defined as being at least 50% of the risk-threshold where pharmacological intervention was recommended according to national clinical guidelines [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…The Hjerteløftet intervention programme is previously described [ 2 ] and is only briefly summarized here. Patients randomized to the intervention group (IG) participated in a 5-day hospital-based lifestyle course in a specialized cardiac rehabilitation hospital (CR Hospital) which focused on PA, nutrition, smoking cessation, stress-management, motivation and individual goal-setting.…”

Section: Methodsmentioning

confidence: 99%

“…This study was approved by the Regional Committee for Medical Health Research Ethics (ID: 2011/561a) as a substudy of the previously described Hjerteløftet Study [ 2 ]. All included patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…On this background we conducted the Hjerteløftet Study, a randomized controlled trial to examine effects of a multimodal intervention programme including a hospital-based lifestyle course and primary care follow-up over 36 months, in individuals with elevated cardiovascular risk [ 2 ]. The intervention resulted in a significant lowering of several validated risk scores (NORRISK, FRAMINGHAM, PROCAM and NORRISK2), when compared to usual care [ 2 ]. Physical activity (PA), stress management, nutrition and smoking cessation were major elements in the programme, and thus may in variable degree all have contributed to the observed reduction in risk scores.…”

Section: Introductionmentioning

confidence: 99%

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Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care

Bergum,

Grimsmo,

Anderssen

et al. 2024

BMC Cardiovasc Disord

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Background Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. Methods A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). Results Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. Conclusions Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group. Trial registration ClinicalTrials.gov (NCT01741428), 04/12/2012.

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Section: Discussionmentioning

confidence: 71%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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