Life-style intervention at the worksite - reduction of cardiovascular risk factors in a randomized study
Life-style intervention at the worksite - reduction of cardiovascular risk factors in a randomized study
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DOI：
10.5271/sjweh.587
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发表时间：
2001-02-01
影响因子：
6.3
通讯作者：
Nyberg, P
中科院分区：
文献类型：
--
作者：
Nilsson, PM;Klasson, EB;Nyberg, P
目的探讨一种可行的工作场所心血管危险筛查方法，探讨长期综合生活方式干预预防心血管疾病的效果。方法采用自填式问卷调查方式，对社会、医疗和工作相关因素进行调查。受访者有454人(80%)。计算心血管风险总分(范围1-20，中位数7.0)，并邀请总分超过8分的128名受试者进行包括采血在内的健康检查。结果干预组在干预过程中体重指数、舒张压、心率、低密度脂蛋白胆固醇和吸烟习惯均显著降低。作为应激反应标志的血清皮质醇最初升高，在干预组恢复正常。对照组的低密度脂蛋白胆固醇也降低了，但血糖和甘油三酯水平升高，吸烟习惯没有改变。1年后干预组患者患病天数减少，而对照组则无明显变化。结论采用随机设计的长期生活方式干预方案，可改善多种心血管危险因素，使晨血皮质醇恢复正常。使用两步筛查计划，在最初的问卷调查之后，对高风险的受试者进行健康检查，在工作场所设置是可行的。
Objectives This study tested a feasible method for screening for cardiovascular risk at the worksite and investigated the effects of a long-term comprehensive program of life style intervention to prevent cardiovascular disease.Methods Employees in the public sector filled out a self-administered questionnaire with questions on social, medical, and work-related factors. The respondents numbered 454 (80%). A score sum for cardiovascular risk was calculated (range 1-20, median 7.0), and the 128 subjects with a sum above 8 were invited to a health examination including blood sampling. Thereafter the subjects were invited to participate, following randomization, in a comprehensive, 18-month, life-style intervention program to improve cardiovascular risk or in a control group.Results The intervention group significantly decreased body mass index, diastolic blood pressure, heart rate, low-density lipoprotein (LDL) cholesterol, and smoking habits during the intervention. The initially elevated serum cortisol, as a marker of stress reaction, normalized in the intervention group. In the control group LDL cholesterol also decreased, but the glucose and triglyceride levels increased, and smoking habits were unchanged. Sick days for a given period decreased after 1 year in the intervention group but not in the control group.Conclusions Several cardiovascular risk factors can be improved and morning serum cortisol normalized during a long-term life-style intervention program with a randomized design using a worksite population of middle-aged subjects. The use of a 2-step screening program, with an initial questionnaire followed by a health check of subjects with elevated risk, is feasible for worksite settings.