Individualised multifactorial lifestyle intervention trial for high-risk cardiovascular patients in primary care

Background: The multiprofessional teams in Finnish health centres are well placed to carry out interventions aimed at the prevention of cardiovascular diseases. Aim: To evaluate the effectiveness of an individually tailored multifactori al lifestyle intervention in primary care for individuals at high risk for cardiovascular disease. Design of study: A randomised controlled trial was conducted over 24 months with interim assessments at six and 12 months. Setting: A health centre in Finland with a patient population of 11 000. Method: One hundred and fifty adults aged 18 to 65 years old with existing cardiovascular disease or multiple risk factors were randomised to active m ultiprofessional risk factor intervention or to standard care. The main out come measure was a change in cardiovascular risk-factor score. Secondary ou tcomes were changes in blood pressure, weight, body-mass index, serum chole sterol, blood glucose, smoking cessation, and exercise habits. Results: The cardiovascular risk score decreased by 28% in the intervention group (23% in the control group), body weight decreased by 3.7% (2%) and t otal cholesterol decreased by 10.8% (6.5%), while time engaged in exercise increased by 39% (43%). Differences were not significant. Conclusions: Cardiovascular risk levels of high-risk individuals decreased in both intervention and control groups. Primary care prevention should be targeted to high-risk persons. Long-term follow-up studies are needed.