Pooled net change in systolic blood pressure ( 16 trials ) was -1.86 ( 95 % CI -3.17 to -0.55 ; p=0.01 ) mm Hg ; diastolic blood pressure ( 15 trials ) , -1.53 ( -2.43 to -0.62 ; p=0.001 ) mm Hg ; body mass index ( 14 trials ) , -0.13 ( -0.26 to -0.01 ; p=0.04 ) kg/m2 ; serum total cholesterol ( 14 trials ) , -0.13 ( -0.19 to -0.07 ; p<0.001 ) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes .
No association was observed between intervention intensity ( number of sessions and intervention duration ) and intervention outcomes .
MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors .
BACKGROUND It is uncertain whether multiple health behaviour change ( MHBC ) interventions are effective for the primary prevention of cardiovascular disease ( CVD ) in primary care .
The impact of health care advice given in primary care on cardiovascular risk. CELL Study Group.
OBJECTIVE To evaluate the additional benefit of " intensive " health care advice through six group sessions , compared with the advice usually offered to subjects with multiple risk factors for cardiovascular disease . DESIGN Prospect i ve , r and omised controlled clinical study lasting 18 months . SETTING 681 subjects aged 30 - 59 years , with at least two cardiovascular risk factors in addition to moderately high lipid concentrations : total cholesterol > or = 6.5 mmol/l on three occasions , triglycerides < 4.0 mmol/l , and ratio of low density lipoprotein cholesterol to high density lipoprotein cholesterol > 4.0 . Most ( 577 ) of the subjects were men . MAIN OUTCOME MEASURE Percentage reduction in total cholesterol concentration ( target 15 % ) ; quantification of the differences between the two types of  health care advice  ( intensive v usual ) for the Framingham cardiovascular risk and for individual risk factors . RESULTS In the group receiving intensive health care advice  total cholesterol concentration decreased by 0.15 mmol/l more ( 95 % confidence interval 0.04 to 0.26 ) than in the group receiving usual advice . The overall Framingham risk dropped by 0.068 more ( 0.014 to 0.095 ) in the group receiving intensive advice , and most of the risk factors showed a greater change in a favourable direction in this group than in the group receiving usual advice , but the differences were seldom significant . The results from question naires completed at the group sessions showed that the subjects improved their lifestyle and diet . CONCLUSION Limited additional benefit was gained from being in the group receiving the intensive health care advice . It is difficult to make an important impact on cardiovascular risk in primary care by using only the practice staff . Better methods of communicating the messages need to be devised
Pooled net change in systolic blood pressure ( 16 trials ) was -1.86 ( 95 % CI -3.17 to -0.55 ; p=0.01 ) mm Hg ; diastolic blood pressure ( 15 trials ) , -1.53 ( -2.43 to -0.62 ; p=0.001 ) mm Hg ; body mass index ( 14 trials ) , -0.13 ( -0.26 to -0.01 ; p=0.04 ) kg/m2 ; serum total cholesterol ( 14 trials ) , -0.13 ( -0.19 to -0.07 ; p<0.001 ) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes .
No association was observed between intervention intensity ( number of sessions and intervention duration ) and intervention outcomes .
MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors .
BACKGROUND It is uncertain whether multiple health behaviour change ( MHBC ) interventions are effective for the primary prevention of cardiovascular disease ( CVD ) in primary care .