Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care

Abstract

Background: Despite well-known preventive effects for future cardiovascular disease (CVD) risk through lifestyle changes, scientific evaluations of lifestyle programmes in primary care are scarce. Moreover, structured lifestyle counselling is still not integrated in everyday clinical practice. We aimed to evaluate change in cardiovascular risk factors and Framingham 10-year risk score of developing CVD in men and women at high cardiovascular risk after participation in a structured lifestyle programme over 1 year. A single-group study was carried out with a 1-year follow-up including before and after measurements.

Methods: The lifestyle programme comprised five appointments to a district nurse over 1 year, focussing on lifestyle habits based on motivational interviewing. Fasting blood samples and anthropometric measurements were obtained at baseline and 1-year follow-up. The 10-year risk of CVD was calculated according to Framingham general CVD risk score.

Results: A total of 404 patients were included in the study. There was a positive change over 1 year in the total study population for all risk factors evaluated. This included improvements in weight, waist circumference, blood pressure, blood lipids, and fasting glucose. The 10-year risk of developing CVD decreased for the total population from 24.8% to 21.4% at 1 year, equivalent to a 14% decrease.

Conclusions: A structured lifestyle programme in primary care contributes to significant improvements of cardiovascular risk factors and the reduction of 10-year risk for CVD for both men and women at high cardiovascular risk.

Keywords:

• Cardiovascular prevention
• cardiovascular risk factors
• Framingham heart study
• hypertension
• lifestyle counselling
• type 2 diabetes mellitus

Acknowledgements

We thank all staff at Citypraktiken, in particular the nurses who performed all counselling sessions. We also thank Professor Mai-Lis Hellenius for the inspiration to start the structured lifestyle programme.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

Funding was received from Praktikertjänst AB, 103 55 Stockholm.

Notes on contributors

Lena Lönnberg

Lena Lönnberg physiotherapist, doctoral student at Centre for Clinical Research, Västerås, Sweden; main research focus on lifestyle counselling for patients at high cardiovascular risk.

Elin Ekblom-Bak

Elin Ekblom-Bak, associate professor at The Swedish School of Sport and Health sciences in Stockholm, Sweden; main research focus on the association between sedentary behaviour, physical activity, and cardiorespiratory fitness on health and disease risk in the adult population.

Mattias Damberg

Mattias Damberg, associate professor at Uppsala University, Uppsala, Sweden; main research focus on the cardiovascular prevention.