Heart:降低心血管风险 护士主导的综合心血管疾病预防项目功不可没

2017-06-13 安雅晶;吴星 环球医学

2008年,研究人员发布了在8个欧洲国家的医院和全科中进行的护士协作多学科、基于家庭的心血管疾病预防项目(EUROACTION)的组群随机对照试验的结果。2017年6月,发表在《Heart》的一项由英国科学家进行的研究考察了以社区为基础的护士主导的综合心血管疾病预防项目的结局。

2008年,研究人员发布了在8个欧洲国家的医院和全科中进行的护士协作多学科、基于家庭的心血管疾病预防项目(EUROACTION)的组群随机对照试验的结果。2017年6月,发表在《Heart》的一项由英国科学家进行的研究考察了以社区为基础的护士主导的综合心血管疾病预防项目的结局。

背景:英国国家指南建议,心血管疾病(CVD)应该作为社区中的疾病家族来进行管理。研究人员在此描述了这种方法的结果。

方法:明确CVD的患者或具有较高多因素风险(HRI)的患者进行了为期12周的以社区为基础的护士主导的预防项目(MyAction),该项目纳入了生活方式和风险因素管理、处方药物和每周锻炼和教育课程。

结果:6年期间,3232名患者参加了初始评估,63%为男性,48%为黑人和少数民族群体。56%的参与者参加了项目末期评估,33%参加了1年评估。项目末期,仅HRI者吸烟流行状态显着降低(-3.7%;P<0.001)。地中海饮食评分在CVD(+1.2;P<0.001)和HRI(+1.5;P<0.001)中都增加,健身水平(CVD:估计Mets最大值+0.8,P<0.001;HRI:估计Mets最大值+0.9,P<0.001)和实现体育运动目标的患者比例(CVD:+40%,P<0.001;HRI:+37%,P<0.001)也是如此。实现血压目标(CVD:+15.4%,P<0.001;HRI:+25%,P<0.001)和低密度脂蛋白胆固醇目标(CVD:+6%,P=0.004;HRI:+23%,P<0.001)的患者比例显着增加。HRI中,他汀和抗高血压药物的使用显着增加。抑郁评分和生活质量测量也显着性改善。多数的改善维持了1年。

结论:结果证实,综合血管预防项目在实践中是可行的,可降低明确CVD患者和具有较高多因素风险患者的心血管风险。

原始出处:

Connolly SB, Kotseva K, et al. Outcomes of an integrated community-based nurse-led cardiovascular disease prevention programme. Heart. 2017 Jun;103(11):840-847. doi: 10.1136/heartjnl-2016-310477. 

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createdName=qingfengqishi5, createdTime=Wed Jun 14 08:58:04 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210278, encodeId=f72f2102e8dc, content=好的,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Jun 13 18:00:15 CST 2017, time=2017-06-13, status=1, ipAttribution=)]
    2017-06-20 lyh994

    能在社区开展这样的研究真的还不错

    0

  5. 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createdName=qingfengqishi5, createdTime=Wed Jun 14 08:58:04 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210278, encodeId=f72f2102e8dc, content=好的,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Jun 13 18:00:15 CST 2017, time=2017-06-13, status=1, ipAttribution=)]
    2017-06-16 ylzr123

    认真学习,不断进步,把经验分享给同好。点赞了!

    0

  6. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Tue Jun 20 12:25:01 CST 2017, time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211369, encodeId=9865211369e4, content=认真学习,不断进步,把经验分享给同好。点赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jun 16 07:04:31 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356331, encodeId=2fc313563316f, content=<a href='/topic/show?id=b0702e84b9' target=_blank 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createdName=qingfengqishi5, createdTime=Wed Jun 14 08:58:04 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210278, encodeId=f72f2102e8dc, content=好的,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Jun 13 18:00:15 CST 2017, time=2017-06-13, status=1, ipAttribution=)]
    2017-06-15 zhaojie88
  7. 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  8. 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    2017-06-15 slcumt
  9. 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createdName=qingfengqishi5, createdTime=Wed Jun 14 08:58:04 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210278, encodeId=f72f2102e8dc, content=好的,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Jun 13 18:00:15 CST 2017, time=2017-06-13, status=1, ipAttribution=)]
    2017-06-14 qingfengqishi5

    学习了,学习了

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=1562564, encodeId=981a1562564dd, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Jun 15 07:58:00 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210562, encodeId=680921056272, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Wed Jun 14 08:58:04 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210278, encodeId=f72f2102e8dc, content=好的,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Tue Jun 13 18:00:15 CST 2017, time=2017-06-13, status=1, ipAttribution=)]
    2017-06-13 Drhzm308

    好的,学习了

    0