Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .
Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM).
BACKGROUND Psychosocial factors are independently associated with increased risk of cardiovascular disease ( CVD ) morbidity and mortality , but the effects of psychosocial factor intervention on CVD are uncertain . We performed a r and omized controlled clinical trial of cognitive behavioral therapy ( CBT ) to measure its effects on CVD recurrence . METHODS The study included 362 women and men 75 years or younger who were discharged from the hospital after a coronary heart disease event within the past 12 months . Patients were r and omized to receive traditional care  ( reference group , 170 patients ) or traditional care plus a CBT program ( intervention group , 192 patients ) , focused on stress management , with 20 two-hour sessions during 1 year . Median attendance at each CBT session was 85 % . Outcome variables were all-cause mortality , hospital admission for recurrent CVD , and recurrent acute myocardial infa rct ion . RESULTS During a mean 94 months of follow-up , the intervention group had a 41 % lower rate of fatal and nonfatal first recurrent CVD events ( hazard ratio [ 95 % confidence interval ] , 0.59 [ 0.42 - 0.83 ] ; P = .002 ) , 45 % fewer recurrent acute myocardial infa rct ions ( 0.55 [ 0.36 - 0.85 ] ; P = .007 ) , and a nonsignificant 28 % lower all-cause mortality ( 0.72 [ 0.40 - 1.30 ] ; P = .28 ) than the reference group after adjustment for other outcome -affecting variables . In the CBT group there was a strong dose-response effect between intervention group attendance and outcome . During the first 2 years of follow-up , there were no significant group differences in traditional risk factors . CONCLUSIONS A CBT intervention program decreases the risk of recurrent CVD and recurrent acute myocardial infa rct ion . This may have implication s for secondary preventive programs in patients with coronary heart disease . Trial Registration clinical trials.gov Identifier : NCT00888485
Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .