Effect on cardiovascular risk of an intervention by family physicians to promote physical exercise among sedentary individuals.
OBJECTIVE
To evaluate the effect of a program promoting physical activity (PEPAF) implemented by family physicians on cardiovascular risk reduction.


METHODS
The cluster randomized clinical trial involved 56 family physicians randomly allocated to an intervention group (n=29) and a control group (n=27). Of the patients recruited, only those aged 30-74 years (1915 PEPAF and 1783 control) were included in the analysis. The intervention involved giving general advice about the benefits of physical activity to all patients and prescribed advice to a subgroup of patients (30%) who agreed to an additional consultation. Outcome measures included risk factors and cardiovascular risk assessed using the Framingham-D'Agostino scale.


RESULTS
A significant decrease from baseline in systolic and diastolic blood pressure and pulse pressure was observed after 12 months in both groups (control group: -2.93 mmHg, -1.81 mmHg and -1.15 mmHg, respectively; PEPAF group: -3.35 mmHg, -1.4 mmHg, and -1.94 mmHg, respectively). The high-density lipoprotein cholesterol level increased (control group: +1.73 mg/dl; PEPAF group: +2.67 mg/dl), while the atherogenic index decreased (by 0.12 and 0.16 in the two groups, respectively), all from baseline (P< .05). Cardiovascular risk decreased by 0.68 (95% confidence interval [CI], 0.13-1.25) in the control group and 0.79 (95%CI, 0.22-1.35) in the PEPAF group. There was no significant difference in the improvement at 12 months between the groups.


CONCLUSIONS
Patients' participation in the project was effective in improving control of risk factors and decreasing cardiovascular risk. No significant difference in outcome was observed between the control group and the group participating in the program promoting physical activity.
Unidad de Investigación de Atención Primaria, Centro de Salud la Alamedilla, REDIAPP, Salamanca, España, Lgarciao@usal.es
Luis
L
García-Ortiz
Gonzalo
G
Grandes
Alvaro
A
Sánchez-Pérez
Imanol
I
Montoya
José A
JA
Iglesias-Valiente
José I
JI
Recio-Rodríguez
Yolanda
Y
Castaño-Sánchez
Manuel A
MA
Gómez-Marcos
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015444:Exercise; D005194:Family Practice; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012307:Risk Factors; D057185:Sedentary Behavior