Risk factors for chronic noncontiguous diseases: Twelve-week prospective study

Abstract

Risk factors (RF) of chronic noncontiguous diseases (CND) are mutual and cannot be observed individually since there is an inter-reaction (interaction of RF in various combinations), what makes so-called personality risk profile for development of particular disease. Almost all CND belong to the group of preventable diseases, because their course may be influenced and changed through RF modification and reduction. Bad habits also contribute to CND incidence. CND prevention is the first priority of primary health care physicians. The main objective of our study was to detect RF in patients during everyday activities of general practitioner, to estimate the risk of CND within the existing RF combination, to show the results of 12-week active monitoring of population with RF of CND, and with already present CND; while the secondary goal was to assess how much population is interested in active collaboration as well as to evaluate the qualification of general medicine teams for work based on defined methodology. The study was multicentric, prospective and interventional. The study included 2086 subjects, aged from 25-64 years, and it was carried out in 17 health centers throughout Serbia in the period January-April 2002. The subjects were selected by method of open clinical experiment. Thereafter, 12-week medical intervention was initiated involving non-pharmacological and pharmacological treatment. The first control was scheduled after 8, and the second after 12 months of intervention. Congruence chi2 test, ANOVA for repeated measurements and Logistic regression were used for statistical data processing. Out of a total of 2086 subjects, the following proportion of them reported specific diagnosis in their medical histories: 77% of them reported arterial hypertension (HTA), 68%--increased body mass (BMI > or = 27Kg/m2), 66%--hyperlipoproteinemia (HLP), 34%--diabetes mellitus (DM), 56%--inadequate physical activity (PA), and 23%--cigarette smoking (CS). On the basis of RF number and combination for genesis and development of CND in our sample, 74.7% of variability (development or risk) may be accounted for angina pectoris (AP), 74.2% for DM+HTA, 70.0% for DM, 79.9% for HTA, 80.8% for myocardial infarction (MI), and 85.8% of variability (development or risk) for cerebrovascular insult (CVI). Twelve-week intervention resulted in reduction of HTA, HLP, glucose, and PC (p<0.001) levels as well as lower BMI and PA (p<0.5). To accomplish the aforementioned goals, continuous mutual activity of an individual, his/her family, health service and community is required, along with occasional evaluation of the obtained results.