A Point-to-Point Simple Telehealth Application for Cardiovascular Prevention: The ESINO LARIO Experience. Cardiovascular Prevention at Point of Care
A Point-to-Point Simple Telehealth Application for Cardiovascular Prevention: The ESINO LARIO Experience. Cardiovascular Prevention at Point of Care
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DOI：
10.1089/tmj.2008.0066
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发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Pagani, Massimo
中科院分区：
文献类型：
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作者：
Malacarne, Mara;Gobbi, Giorgio;Pagani, Massimo
最近的流行病学证据表明，慢性退行性疾病，特别是心血管疾病，是死亡和生活质量受损的主要原因。最近的估计表明，在一些临床病例中，财政资源的小幅增加可能足以最大限度地减少每个人心血管风险升高的后果。生活方式的选择，特别是增加体育锻炼，可能会强烈影响心血管疾病的风险，建议重新设计预防策略，结合药理学和行为干预。根据我们最近在全球医疗服务互动远程咨询网络（INCAS）系统方面的经验，我们设计了一个更简单的点对点远程医疗基础设施，用于心血管风险降低计划，预计人口的接受程度很高，成本非常有限。该模型在意大利Esino Lario山村的181名受试者（年龄18-80岁）中进行了测试。这些受试者接受了筛选试验，以评价心律失常和心脏代谢风险（14%的受试者发现心律失常，43%的受试者观察到动脉收缩压高于140 mm Hg，31%的受试者观察到动脉舒张压高于90 mm Hg）。这项研究证明了缩小规模的远程保健应用的可行性，特别适合偏远地区，如山村的心血管疾病预防。
Recent epidemiological evidence indicates that chronic degenerative diseases, notably cardiovascular, represent the major toll in terms of death and of impaired quality of life. Recent estimates indicate that a small increase in financial resources in a number of clinical cases may be sufficient to minimize the consequences of elevated cardiovascular risk per individual. The observation that lifestyle choices, and in particular increased physical exercise, might strongly impact cardiovascular risk, suggests a redesign of preventive strategies, based on the combination of pharmacological and behavioral interventions. Following our recent experience with the INteractive teleConsultation network for worldwide healthcAre Services (INCAS) system, we designed a simpler point-to-point telehealth infrastructure, to be employed in cardiovascular risk reduction programs, predicting a high level of acceptance from the population, at the cost of very limited investment. This model was tested on 181 subjects ( ages 18-80 years) in the Italian mountain village of Esino Lario. These subjects underwent a screening test to evaluate arrhythmia and cardiometabolic risks (arrhythmias were found in 14% of subjects, systolic arterial pressure was observed in 43% of subjects above 140 mm Hg, diastolic arterial pressure in 31% above 90 mm Hg). This study demonstrates the feasibility of a scaled-down telehealth application particularly suited to cardiovascular prevention in remote areas, such as in mountain villages.