Conclusions This review demonstrates the potential for multifactorial interventions aim ed at individuals selected by CVD risk scores for lowering CVD risk and mortality .
However , the majority of studies in this area do not provide an intensity of intervention which is sufficient in significantly reducing CVD mortality or vali date d CVD risk
Objectives The high prevalence of cardiovascular disease ( CVD ) and the increased cost of treatment have prompted strategies for the primary prevention of CVD in the UK to move towards the use of vali date d CVD risk scores to identify individuals at the highest risk .
There are no review s evaluating the effectiveness of this strategy as a means of reducing CVD risk or mortality .
This review summarizes current evidence for and against the use of vali date d CVD risk scores for the primary prevention of CVD .
One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk
Background : In this study , we tested the efficacy of a low-intensity lifestyle intervention aim ed at reducing the risk of cardiovascular disease among mid-life individuals . Methods : We conducted a r and omized controlled trial in which participants were r and omly assigned either to receive a health report card with counselling ( from a Telehealth nurse ) on smoking , exercise , nutrition and stress or to receive usual care . The patients were divided into 2 groups on the basis of risk : the primary prevention group , with a Framingham risk score of 10 % or higher ( intervention , n = 157 ; control , n = 158 ) , and the secondary prevention group , who had a diagnosis of coronary artery disease ( intervention , n = 153 ; control , n = 143 ) . The primary outcome was a change in the Framingham global risk score between baseline and 1-year follow-up . Data were analyzed separately for the 2 prevention groups using an intention-to-treat analysis controlling for covariates . Results : Within the primary prevention group , there were statistically significant changes for the treatment group relative to the controls , from baseline to year 1 , in Framingham score ( intervention , –3.10 [ 95 % confidence interval ( CI ) –3.98 to –2.22 ] ; control , –1.30 [ 95 % CI –2.18 to –0.42 ] ; p < 0.01 ) and scores for total cholesterol ( intervention , –0.41 [ 95 % CI –0.59 to –0.23 ] ; control , –0.14 [ 95 % CI –0.32 to 0.04 ] ; p < 0.05 ) , systolic blood pressure ( intervention , –7.49 [ 95 % CI –9.97 to –5.01 ] ; control , –3.58 [ 95 % CI –6.08 to –1.08 ] ; p < 0.05 ) , nutrition level ( intervention , 0.30 [ 95 % CI 0.13 to 0.47 ] ; control , –0.05 [ 95 % CI –0.22 to 0.12 ] ; p < 0.01 ) , and health confidence ( intervention , 0.20 [ 95 % CI 0.09 to 0.31 ] ; control , 0.04 [ 95 % CI –0.07 to 0.15 ] ; p < 0.05 ) , with adjustment for covariates . No significant changes in outcome variables were found for the secondary prevention group . Interpretation : We found evidence for the efficacy of an intervention addressing multiple risk factors for primary prevention at 1 year using Framingham risk score report cards and telephone counselling . ( Requirement for clinical trial registration waived [ enrolment completed before requirement became applicable ] .
Conclusions This review demonstrates the potential for multifactorial interventions aim ed at individuals selected by CVD risk scores for lowering CVD risk and mortality .
However , the majority of studies in this area do not provide an intensity of intervention which is sufficient in significantly reducing CVD mortality or vali date d CVD risk
Objectives The high prevalence of cardiovascular disease ( CVD ) and the increased cost of treatment have prompted strategies for the primary prevention of CVD in the UK to move towards the use of vali date d CVD risk scores to identify individuals at the highest risk .
There are no review s evaluating the effectiveness of this strategy as a means of reducing CVD risk or mortality .
This review summarizes current evidence for and against the use of vali date d CVD risk scores for the primary prevention of CVD .