There were no significant effects of interventions on mean blood pressure or cholesterol levels , prescribing , smoking status or body mass index .
There was some suggestion of a " ceiling effect " whereby interventions have a diminishing beneficial effect once certain levels of risk factor management are reached .
There is weak evidence that regular planned recall of patients for appointments , structured monitoring of risk factors and prescribing , and education for patients can be effective in increasing the proportions of patients within target levels for cholesterol control and blood pressure .
BACKGROUND Ischaemic heart disease ( IHD ) is a major cause of mortality and morbidity and its prevalence is set to increase .
Secondary prevention aims to prevent subsequent acute events in people with established IHD .
While the benefits of individual medical and lifestyle interventions is established , the effectiveness of interventions which seek to improve the way secondary preventive care is delivered in primary care or community setting s is less so .
OBJECTIVES To assess the effectiveness of service organisation interventions , identifying which types and elements of service change are associated with most improvement in clinician and patient adherence to secondary prevention recommendations relating to risk factor levels and monitoring ( blood pressure , cholesterol and lifestyle factors such as diet , exercise , smoking and obesity ) and appropriate prophylactic medication .
Effects of preventive group education on the resistance of LDL against oxidation and risk factors for coronary heart disease in bypass surgery patients
BACKGROUND . Comprehensive preventive education for heart patients is effective in reducing cardiac events . However , very dem and ing counselling protocol s can not easily be implemented as an integral part of clinical practice in hospitals . AIM . To evaluate whether recurrent preventive group education for coronary artery bypass grafting patients affects the resistance of LDL against oxidation and the classical risk factors for coronary heart disease . METHODS . A prospect i ve , controlled study with one-year follow-up was carried out in Southern Finl and . Coronary artery bypass patients were allocated late ( S 18 months ) after the operation in the intervention and control groups . RESULTS . Seventy two patients ( 65 men and 7 women ) completed the study . Twelve-hour group education on healthy life-style had a significant ( 25 % , P = 0.01 ) but transient positive effect on the resistance of LDL against oxidation . There was a trend towards increased physical activity in the intervention group . The impact of education on patients ' weight was also more consistent ( 1.2 kg at 12 months , P < 0.05 ) , whereas long-term effects on fibrinogen and serum lipids were small . CONCLUSIONS . Repeated group education applied as an economically feasible part of specialist care had only small positive effects on patients ' risk factors . There was a significant , but transient , increase in the resistance of LDL against oxidation . However , effective lipid lowering drug treatment is indicated for most coronary artery bypass patients rather than repeated health education alone
There were no significant effects of interventions on mean blood pressure or cholesterol levels , prescribing , smoking status or body mass index .
There was some suggestion of a " ceiling effect " whereby interventions have a diminishing beneficial effect once certain levels of risk factor management are reached .
There is weak evidence that regular planned recall of patients for appointments , structured monitoring of risk factors and prescribing , and education for patients can be effective in increasing the proportions of patients within target levels for cholesterol control and blood pressure .
BACKGROUND Ischaemic heart disease ( IHD ) is a major cause of mortality and morbidity and its prevalence is set to increase .
Secondary prevention aims to prevent subsequent acute events in people with established IHD .
While the benefits of individual medical and lifestyle interventions is established , the effectiveness of interventions which seek to improve the way secondary preventive care is delivered in primary care or community setting s is less so .
OBJECTIVES To assess the effectiveness of service organisation interventions , identifying which types and elements of service change are associated with most improvement in clinician and patient adherence to secondary prevention recommendations relating to risk factor levels and monitoring ( blood pressure , cholesterol and lifestyle factors such as diet , exercise , smoking and obesity ) and appropriate prophylactic medication .