Outcomes of comprehensive lifestyle modification in inpatient setting.
OBJECTIVE
To examine the effectiveness of a 4-week inpatient non-pharmacological risk factor modification programme for individuals with the metabolic syndrome. The aim of the program was to reduce patients' over risks for stroke and myocardial infarction.


METHODS
A prospective clinical study including 2468 patients--1096 men and 1372 women--with and average age of 50 +/- 10 years. The patients were referred to the programme from primary care units and hospitals where treatment options were exhausted.


RESULTS
All risk factor levels for stroke and myocardial infarction decreased. The reduction of weight among men was 4.7 +/- 2.6 kg and 3.8 +/- 1.8 kg among women from an initial weight of 96 +/- 17 kg and 85 +/- 16 kg, respectively. The patients systolic and diastolic blood pressure decreased by 15/10 mmHg for men and 14/9 mmHg among women from initial average for the whole population of 148/90 +/- 19/11 mmHg and 146/87 +/- 19/12 mmHg, respectively. The greatest decrease in weight and blood pressure occurred in men and women with an initial body mass index of > or = 30 and with a diastolic blood pressure of > or = 90; in this group, the average reductions in weight were 5.8 +/- 2.4 kg for men and 4.4 +/- 1.7 kg for women; the reductions in systolisk/diastolisk blood pressure were 22/15 +/- 16/9 mmHg (p < 0.001) for both men and women. A reduction of medication (DDD) although not a goal was also achieved.


CONCLUSIONS
The results prove the value of a comprehensive and highly structured inpatient approach to lifestyle modification.


CONCLUSIONS
The results should give cause to trials with half-way strategies integrating features from the inpatient programme into the design of risk factor interventions.
Kaati
Gunnar
G
Department of Public Health and Clinical Medicine, University of Umeå, S-90185 Umeå, Sweden. Gunnar.Kaati@socmed.umu.se
Bygren
Lars-Olov
LO
Vester
Monica
M
Karlsson
AnnBrith
A
Sjöström
Michael
M
D000368:Aged; D015992:Body Mass Index; D003479:Curriculum; D003971:Diastole; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000517:prevention & control; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D007297:Inpatients / Q000193:education*; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control; D013548:Sweden; D013599:Systole; D015431:Weight Loss