A 12-week nurse-led prevention programme significantly increased the proportion of patients achieving blood pressure (CVD +15.4%, HRI +25%) and LDL cholesterol targets (CVD +6%, HRI +23%).
Observational (n=3,232)
Does a 12-week community-based nurse-led prevention programme improve cardiovascular risk factors in patients with established CVD or at high multifactorial risk?
An integrated community-based nurse-led cardiovascular disease prevention programme significantly improves lifestyle factors and risk factor targets in patients with or at high risk for CVD.
BACKGROUND: National guidance for England recommends that cardiovascular disease (CVD) should be managed as a family of diseases in the community. Here, we describe the results of such an approach. METHODS: Patients with established CVD or who were at high multifactorial risk (HRI) underwent a 12-week community-based nurse-led prevention programme (MyAction) that included lifestyle and risk factor management, prescription of medication and weekly exercise and education sessions. RESULTS: Over a 6-year period, 3232 patients attended an initial assessment; 63% were male, and 48% belonged to black and minority ethnic groups. 56% attended an end-of-programme assessment, and 33% attended a one year assessment. By the end of the programme, there was a significant reduction in smoking prevalence but only in HRI (-3.7%, p<0.001). Mediterranean diet score increased in both CVD (+1.2, p<0.001) and HRI (+1.5; p<0.001), as did fitness levels (CVD +0.8 estimated Mets maximum, p<0.001, HRI +0.9 estimated Mets maximum, p<0.001) and the proportions achieving their physical activity targets (CVD +40%, p<0.001, HRI +37%, p<0.001). There were significant increases in proportions achieving their blood pressure (CVD +15.4%, p<0.001, HRI +25%, p<0.001 and low-density lipoprotein cholesterol targets (CVD +6%, p=0.004, HRI +23%, p<0.001). Statins and antihypertensive medications significantly increased in HRI. Significant improvements in depression scores and quality-of-life measures were also seen. The majority of improvements were maintained at 1 year. CONCLUSION: These results demonstrate that an integrated vascular prevention programme is feasible in practice and reduces cardiovascular risk in patients with established CVD and in those at high multifactorial risk.
Connolly et al. (Thu,) conducted a observational in Cardiovascular disease or high multifactorial risk (n=3,232). 12-week community-based nurse-led prevention programme (MyAction) was evaluated on Cardiovascular risk factors including smoking, diet, fitness, blood pressure, and LDL cholesterol. A 12-week nurse-led prevention programme significantly increased the proportion of patients achieving blood pressure (CVD +15.4%, HRI +25%) and LDL cholesterol targets (CVD +6%, HRI +23%).