Lifestyle counselling in primary care: long-term effects on cholesterol level.
OBJECTIVE
To evaluate the long-term effectiveness of lifestyle counselling for low-moderate cardiovascular (CV) risk subjects in primary care.


METHODS



METHODS
Prospective comparison of baseline vs post-intervention, and comparison of enrolled patients vs control subjects extracted from a large primary care database.


METHODS
94 general practices in Italy.


METHODS
All the 20-70-year-old hypercholesterolaemic subjects who did not qualify for statin treatment according to the guidelines and who were seen on 12 predetermined working days; 713 patients; 94 general practitioners.


METHODS
Short (5-10 min) educational intervention (qualitative dietary advice, encouraging walking or other aerobic physical activities); handing out simple dietetic advice at physician discretion.


METHODS
Total cholesterol level and global CV risk calculated according to the Framingham equation.


RESULTS
Total cholesterol and global CV risk (10 years) decreased by 0.31 mmol/l (p < 0.0001, 95% CI 0.23-0.40) and 1.35% (p < 0.01, 95% CI -1.73 to -0.97), respectively, after a 54-month follow-up. Enrolled patients showed a greater total cholesterol decrease than control patients: 2.24% (p < 0.05, 95% CI 0.58-3.91%).


CONCLUSIONS
A simple, office-based, long-term, lifestyle counselling programme produces a small, but clinically significant reduction of total cholesterol and of global CV risk. This result should encourage GPs to systematically offer simple, unstructured lifestyle counselling to all their patients.
Filippi
Alessandro
A
Italian College of General Practitioners, Florence, Italy.
Tedeschi
Luca
L
Parretti
Damiano
D
Ricci
Stefano
S
Morelli
Patrizia
P
Grilli
Piero
P
Rossi
Alessandro
A
Innocenti
Francesco
F
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D003376:Counseling; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000628:therapy; D007558:Italy; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D055815:Young Adult
D002784:Cholesterol