Abstract
BackgroundThe health benefits of physical exercise have been shown to be important in the prevention of cardiovascular diseases in patients with hypertension, dyslipidaemia or diabetes. However, few strategies have demonstrated efficacy and practicality in the promotion of physical exercise among this group of patients in general practice.MethodsThe PEPPER clinical study is a randomised controlled trial to evaluate the efficacy over a period of 12 months, in terms of physical activity level, of an intervention based on structured information delivery, a personalised written physical activity prescription in number of steps per day, a pedometer and a pedometer logbook, in 35 to 74-year-old patients with cardiovascular risk factors. 140 patients will be recruited in 15 GP practices and randomised in the intervention group or in the control group where patients will receive verbal advice of physical exercise. The primary outcome is the change at three months in total energy expenditure measured by an accelerometer over a 7-day period. Secondary outcomes include changes at 3 and 12 months in physical activity levels (accelerometer and International Physical Activity Questionnaire), quality of life (SF-36), blood pressure, weight, waist circumference, perceived obstacles to physical activity and patient compliance with the recommended strategy. Both groups will be compared using mixed models.DiscussionThe results are expected at the end of 2019. If the intervention proves effective in durably increasing the level of physical activity, this strategy could be tested in a larger trial to examine its impact on cardiovascular diseases.Trial registrationUS National Institutes of Health Clinical Trials Registry NCT02317003, December 15, 2014.
Highlights
The health benefits of physical exercise have been shown to be important in the prevention of cardiovascular diseases in patients with hypertension, dyslipidaemia or diabetes
All cause mortality risk is increased in sedentary individuals by 20 to 30% compared to individuals having moderate intensity physical activity for 30 min a day, four days a week [1]
Recent cohort studies by Moore, et al [5] and Wen, et al [6], on large samples of hundreds of thousands of individuals in the USA, Sweden and China, have demonstrated significant benefits of physical exercise: 15 min of daily moderate intensity exercise produce a gain of 2.5 years of life compared to sedentary individuals, all cause mortality risk are reduced by 16% for active hypertensive or dyslipidaemic individuals compared to inactive individuals, and by 22% for the subgroup of diabetic or pre-diabetic patients
Summary
The health benefits of physical exercise have been shown to be important in the prevention of cardiovascular diseases in patients with hypertension, dyslipidaemia or diabetes. Recent cohort studies by Moore, et al [5] and Wen, et al [6], on large samples of hundreds of thousands of individuals in the USA, Sweden and China, have demonstrated significant benefits of physical exercise: 15 min of daily moderate intensity exercise produce a gain of 2.5 years of life compared to sedentary individuals, all cause mortality risk are reduced by 16% for active hypertensive or dyslipidaemic individuals compared to inactive individuals, and by 22% for the subgroup of diabetic or pre-diabetic patients. In many countries, the most prevalent strategy to promote physical activity in primary care remains verbal advice to patients [16], with limited results
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