Effectiveness of Non-pharmacological Interventions in Patients With Cardiovascular Risk Factors in Primary Care
Condition: Cardiovascular Disease
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      The principal objective is analyzed whether a selective intervention no pharmacological (use
      of ABPM +/- prescription of physical exercise) for cardiovascular risk factors in patients
      with high cardiovascular risk in primary prevention is associated with a decrease in
      cardiovascular risk measured using the risk Score tables for countries with a low risk. It
      will be independently analized the effectiveness of systematic use of ABPM and the
      prescription of physical exercise.
    

Detailed description: 
      Cardiovascular disease continues to be the main cause of death in Western countries, with a
      very high prevalence (affecting >1 in every 3 adult Americans), and contributes as one of the
      highest annual healthcare costs. There is still enormous potential for improving prevention
      although notable efforts have already been made. In the Spanish population, the following
      cardiovascular risk factors have been identified as being most prevalent: arterial
      hypertension, dyslipidemia, having a sedentary lifestyle, tobaccoism, obesity and diabetes.

      Essential Arterial Hypertension (EAH) is the most prevalent cardiovascular risk factor in the
      world and the main cause of cardiovascular disease. There are many clinical practice guides
      which recommend carrying out moderate physical activity to prevent, delay or reduce
      hypertension, given that the practice of community interventions with physical activity have
      been efficient.

      The indication to perform Itinerant Monitorization blood pressure in the diagnosis of
      hypertension is included in the latest draft of the clinical practice guideline from NICE,
      National Institute for Health and Clinical Excellence .

      Other cardiovascular risk factor to take into account is dyslipidemia, the prevalence of
      dyslipidemia is 16.2% in adults aged over 20 years. For this condition, physical activity is
      also recommended.

      When faced with a sedentary lifestyle or physical inactivity two intervention measures are
      available for reducing its incidence: verbal healthcare advice (taking advantage of the
      patients visit to the consultation) and the prescription of physical exercise.

      Taking into account the interventions mentioned that can be carried out in the face of risk
      factors, and that a multifactorial intervention is more efficient that individual
      interventions, the investigators have designed a clinical trial which attempts to improve
      most of the principal risk factors. The objective is to reduce the cardiovascular risk of
      patients using a multifactorial intervention on hypertension, dyslipidemia, sedentary
      lifestyle. The investigators will evaluate the efficiency of a program for official
      prescriptions for physical exercise compared to structured verbal advice in hypertense
      patients undergoing treatment and who have another risk factors (dyslipidemia being treated
      for more than one year or they are smokers), including action to improve the treatment
      adaptation for the hypertension (ABPM).
    

Intervention name(s): therapeutic exercise; ABPM ambulatory blood pressure monitoring
Intervention type(s): Behavioral; Device
Intervention description(s): The duration of the groups is planned to be from 12 weeks with 3 programmed sessions per week. physical activity programmed by an instructor in patient with high risk of cardiovascular.; Arterial pressure is a biological variable which fluctuates over a 24 hour period depending on the period of activity/rest, which is known as circadian the BP rhythm. Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) vary, on average, more than 50 mm Hg throughout the day in a normotensive adult.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cardiovascular Disease;; primary prevention;; physical activity;; Blood Pressure Monitoring, Ambulatory