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Research

One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk

Andrew Wister, Nadine Loewen, Holly Kennedy-Symonds, Brian McGowan, Bonnie McCoy and Joel Singer
CMAJ October 09, 2007 177 (8) 859-865; DOI: https://doi.org/10.1503/cmaj.061059
Andrew Wister PhD
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Nadine Loewen MD
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Holly Kennedy-Symonds MHSc
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Brian McGowan MD
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Bonnie McCoy MA
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Joel Singer PhD
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  • Résumé

    One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk

    Andrew Wister PhD, Nadine Loewen MD, Holly Kennedy-Symonds MHSc, Brian McGowan MD, Bonnie McCoy MA, Joel Singer PhD

    Department of Gerontology (Wister), Simon Fraser University; Fraser Health (Loewen); Acute Care and Special Projects, Burnaby Hospital, Fraser Health (Kennedy-Symonds); Emergency Medicine, Burnaby Hospital, Fraser Health (McGowan), Burnaby, BC; Centre for Health Economics in Cancer, BC Cancer Research Centre (McCoy); Department of Health Care and Epidemiology (Singer), University of British Columbia, Vancouver, BC

    Correspondance : Dr Andrew V. Wister, Professor and Chair, Department of Gerontology, Simon Fraser University, Vancouver Campus, 2800–515 W Hastings St., Vancouver BC  V6B 5K3; fax 604 291-5066; wister{at}sfu.ca

    Contexte : Au cours de cette étude, nous avons testé l’efficacité d’une intervention de faible intensité portant sur les habitudes de vie et visant à réduire le risque de maladie cardiovasculaire chez les personnes d’âge mûr.

    Méthodes : Nous avons effectué une étude contrôlée randomisée au cours de laquelle les participants choisis au hasard ont reçu un bilan de santé et des conseils (d’une infirmière travaillant en télésanté) sur le tabagisme, l’exercice, la nutrition et le stress, ou ont reçu les soins habituels. On a réparti les patients en deux groupes, en fonction du risque : le groupe de prévention primaire, qui présentait un score de risque de Framingham de 10 % ou plus (intervention, n = 157; groupe témoin, n = 158), et le groupe de prévention secondaire avec coronaropathie diagnostiquée (intervention, n = 153; groupe témoin, n = 143). Un changement du score de risque global de Framingham entre le niveau de référence et le suivi à un an a constitué le principal résultat. On a analysé les données séparément pour les deux groupes de prévention et utilisé une analyse de l’intention de traiter en tenant compte des covariables.

    Résultats : Dans le groupe de prévention primaire, on a constaté chez les sujets du groupe de traitement par rapport aux sujets du groupe témoin des changements statistiquement significatifs entre le niveau de référence et celui de la première année pour le score de Framingham (groupe d'intervention, –3,10 intervalle de confiance à 95 % (IC) –3,98 à –2,22; groupe témoin, –1,30 IC à 95 %, –2,18 à –0,42; p < 0,01) et pour les scores relatifs au cholestérol total (groupe d'intervention, –0,41 IC à 95 %, –0,59 à –0,23; groupe témoin, –0,14 IC à 95 %, –0,32 à 0,04; p < 0,05), à la tension artérielle systolique (intervention, –7,49 IC à 95 %, –9,97 à –5,01; témoin, –3,58 IC à 95 %, –6,08 à –1,08; p < 0,05), au niveau de nutrition (intervention, 0,30 IC à 95 %, 0,13 à 0,47; témoin, –0,05 IC à 95 %, –0,22 à 0,12; p < 0,01) et à la confiance en la santé (intervention, 0,20 IC à 95 %, 0,09 à 0,31; témoin, 0,04 IC à 95 %, –0,07 à 0,15; p < 0,05), compte tenu de covariables. Dans le groupe de prévention secondaire, on n’a constaté aucun changement significatif des variables mesurées.

    Interprétation : Nous avons démontré l’efficacité d’une intervention portant sur de multiples facteurs de risque en prévention primaire à un an en utilisant des bilans du score de risque de Framingham et des conseils téléphoniques. (Étude dispensée de l’obligation d’inscription inscription des sujets terminée avant que l’obligation entre en vigueur.)

  • Online Appendix

    Files in this Data Supplement:

    • Appendix 1: Simon Fraser Heart Health Report Card

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  • Alter, D. A. (2007). Therapeutic lifestyle and disease-management interventions: pushing the scientific envelope. CMAJ, 177(8), 887-889. Accessed February 05, 2023. https://doi.org/10.1503/cmaj.071230.
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One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk
Andrew Wister, Nadine Loewen, Holly Kennedy-Symonds, Brian McGowan, Bonnie McCoy, Joel Singer
CMAJ Oct 2007, 177 (8) 859-865; DOI: 10.1503/cmaj.061059

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One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk
Andrew Wister, Nadine Loewen, Holly Kennedy-Symonds, Brian McGowan, Bonnie McCoy, Joel Singer
CMAJ Oct 2007, 177 (8) 859-865; DOI: 10.1503/cmaj.061059
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