A novel family-based intervention trial to improve heart health: FIT Heart: results of a randomized controlled trial.
A novel family-based intervention trial to improve heart health: FIT Heart: results of a randomized controlled trial.
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DOI：
10.1161/circoutcomes.108.825786
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发表时间：
2008-11
期刊：
影响因子：
--
通讯作者：
Oz MC
中科院分区：
文献类型：
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作者：
Mosca L;Mochari H;Liao M;Christian AH;Edelman DJ;Aggarwal B;Oz MC
心血管疾病（CVD）患者的家庭成员可能由于共同的基因和生活方式而增加风险。患有心血管疾病的家庭成员住院治疗可能是采取预防措施的"激励时刻"。在健康成年家庭成员中进行了一项随机对照临床试验（N = 501; 66%女性; 36%非白人;平均年龄，48岁），以评价一种特殊干预（SI），包括个性化风险因素筛查、治疗性生活方式改变咨询，以及向医生报告的进展报告与对照干预（CIN）的主要结局，低密度脂蛋白胆固醇（LDL-C）和其他风险因素的平均百分比变化。在基线和1年（94%随访）时获得了有效的饮食评估和标准化风险因素。基线时，93%的受试者的饱和脂肪占总热量摄入的≥ 7%，79%的受试者的LDL-C水平非最佳（其中50%的受试者不知情）。SI与CIN在LDL-C的平均百分比变化方面无差异（分别为− 1%与− 2%; P = 0.64），因为两组中LDL-C的显著降低相似（分别为− 4.4 mg/dL和− 4.5 mg/dL）。SI与CIN相比饮食评分显著改善（P = 0.04）。高密度脂蛋白胆固醇在CIN中显著下降，但在SI中没有显著下降（-3.2%[95%CI，-5.1至-1.3] vs +0.3%[95%CI，-1.7至+2.4]; P = 0.01）。在1年时，SI受试者比对照组更可能每周锻炼> 3天（P = 0.04）。在降低主要终点LDL-C方面，SI并不比CIN更有效。筛查过程发现，许多住院CVD患者的家庭成员不知道他们的风险因素，需要进一步的工作来开发和测试干预措施以降低他们的CVD风险。
Family members of patients with cardiovascular disease (CVD) may be at increased risk due to shared genes and lifestyle. Hospitalization of a family member with CVD may represent a “motivational moment” to take preventive action. A randomized, controlled clinical trial was conducted in healthy adult family members (N=501; 66% female; 36% nonwhite; mean age, 48 years) of patients hospitalized with CVD to evaluate a special intervention (SI) with personalized risk factor screening, therapeutic lifestyle-change counseling, and progress reports to physicians versus a control intervention (CIN) on the primary outcome, mean percent change in low-density lipoprotein cholesterol (LDL-C), and other risk factors. Validated dietary assessments and standardized risk factors were obtained at baseline and 1 year (94% follow-up). At baseline, for 93% of subjects, saturated fat comprised ≥7% of total caloric intake, and 79% had nonoptimal LDL-C levels (of which 50% were unaware). There was no difference in the SI versus the CIN with respect to the mean percent change in LDL-C (−1% versus −2%, respectively; P=0.64), owing to a similar significant reduction in LDL-C in both groups (−4.4 mg/dL and −4.5 mg/dL, respectively). Diet score significantly improved in the SI versus the CIN (P=0.04). High-density lipoprotein cholesterol declined significantly in the CIN but not in the SI (−3.2% [95% CI, −5.1 to −1.3] versus +0.3% [95% CI, −1.7 to +2.4]; P=0.01). At 1 year, SI subjects were more likely than controls to exercise >3 days per week (P=0.04). The SI was not more effective than the CIN in reducing the primary end point, LDL-C. The screening process identified many family members of hospitalized patients with CVD who were unaware of their risk factors, and further work is needed to develop and test interventions to reduce their CVD risk.