The impact of cardiovascular risk factor case management on the metabolic syndrome in a primary prevention population: results from a randomized controlled trial.
No study has examined the effect of case management on the development of the metabolic syndrome. The authors randomized 450 consenting, asymptomatic men and women to a 6-month cardiovascular case management program or usual care. Participants were reassessed at 1 year for change in a composite measure of five factors that define the metabolic syndrome. Of the cohort (mean age 42 years; 79% male), 46% had at least one metabolic syndrome factor and 4.3% had the metabolic syndrome. At 1 year, there was greater improvement in motivation to change in the case management group (+0.58 vs. +0.06, 10-point scale; p = 0.001), lower incidence of the metabolic syndrome (1.5% vs. 4.5%; p = 0.12), and lower prevalence (decrease of 0.8% vs. increase of 2.6%; p = 0.04). A 6-month case management program focused on cardiovascular risk factors had a modest effect on the prevalence of the metabolic syndrome in this primary prevention screening population after 1 year. Further study is needed to clarify the overall health impact of preventing the metabolic syndrome.
O'Malley
Patrick G
PG
Department of Medicine, Division of General Internal Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. patrick.omalley@na.amedd.army.mil
Kowalczyk
Courtney
C
Bindeman
Jody
J
Taylor
Allen J
AJ
D000328:Adult; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D019090:Case Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods*; D014481:United States / Q000453:epidemiology
D002317:Cardiovascular Agents