title: Comparing the effectiveness of two cardiovascular prevention programmes for highly educated professionals in general practice: a randomised clinical trial.
abstract: BACKGROUND
  Cardiovascular disease is a major cause of mortality and morbidity and its prevalence is set to increase. While the benefits of medical and lifestyle interventions are established, the effectiveness of interventions which seek to improve the way preventive care is delivered in general practice is less so. The aim was to study and to compare the effectiveness of 2 intervention programmes for reducing cardiovascular risk factors within general practice.
  
  
  METHODS
  A randomised controlled trial was conducted in Belgium between 2007-2010 with 314 highly educated and mainly healthy professionals allocated to a medical (MP) or a medical + lifestyle (MLP) programme. The MP consisted of medical assessments (screening and follow-up) and the MLP added a tailored lifestyle change programme (web-based and individual coaching) to the MP. Primary outcomes were total cholesterol, blood pressure, and body mass index (BMI). The secondary outcomes were smoking status, fitness-score, and total cardiovascular risk.
  
  
  RESULTS
  The mean age was 41 years, 95 (32%) participants were female, 7 had a personal cardiovascular event in their medical history and 3 had diabetes. There were no significant differences found between MP and MLP in primary or secondary outcomes. In both study conditions decreases of cholesterol, systolic blood pressure, and diastolic blood pressure were found. Unfavourable increases were found for BMI (p < .05). A significant decrease of the overall cardiovascular risk was reported (p < .001).
  
  
  CONCLUSIONS
  Both interventions are effective in reducing cardiovascular risk. In our population the combined medical and lifestyle programme was not superior to the medical programme.
  
  
  BACKGROUND
  ISRCTN23940498.
authors.affiliation: Faculty of Medicine, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium. neree.claes@uhasselt.be
authors.forename: Neree
authors.initials: N
authors.lastname: Claes
authors.forename: Nele
authors.initials: N
authors.lastname: Jacobs
authors.forename: Els
authors.initials: E
authors.lastname: Clays
authors.forename: Ward
authors.initials: W
authors.lastname: Schrooten
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000191:economics / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome