Cardiovascular Disease In Community Research Articles

Peer-led lifestyle interventions for the primary prevention of cardiovascular disease in community: a systematic review of randomised controlled trials

BackgroundPeer-led lifestyle interventions have gained recognition as effective approaches for managing and preventing chronic diseases. However, there remains a critical knowledge gap regarding the impact and effectiveness of peer-led interventions specifically in the primary prevention of cardiovascular disease (CVD). Our systematic review aims to synthesise the available evidence and evaluate the impact of peer-led lifestyle interventions, providing invaluable insights that can guide the development of peer-led strategies for preventing CVD.MethodsSystematic database searches were conducted on Ovid Medline, Embase, Cochrane Centre for Controlled Trials, PubMed and Scopus to source peer-reviewed articles published between 2013 and 2023. Reference lists of the included publications were also manually searched.ResultsFourteen unique randomised controlled trials were identified, of which three were pilot studies. Most of the interventions were conducted among individuals at moderate to high risk of CVD and lasted for a year. There is a variety of components in intervention delivery, including group discussions and individual counselling. Peer leader training mostly covered intervention delivery, communication, and research-specific skills. Systolic blood pressure showed the most promising CVD-related improvement, while mixed results were found for several other dietary and lifestyle behavioural outcomes.ConclusionPeer-led lifestyle interventions have shown varying effectiveness in cardiovascular health outcomes. The competencies and roles of peer leaders were identified to guide future intervention development with a more comprehensive approach to the primary prevention of CVD.

Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial

BackgroundPublic health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the ‘Family Health Strategy’ in low-income communities at Rio de Janeiro City, Brazil (known as ‘favelas’).MethodsPatients were matched for age and assigned into three groups: a) FA (supervised training, n = 53; 60.5 ± 7.7 yrs); b) DA (self-reported, n = 43; 57.0 ± 11.2 yrs); c) PI (n = 48; 57.0 ± 10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications.ResultsAt baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P > 0.05). However, diabetes prevalence was 10–15% lower in DA vs. FA and PI (P < 0.05). Intention-to-treat analysis showed significant reductions after intervention (P < 0.05) in FA for total cholesterol (~ 10%), LDL-C (~ 15%), triglycerides (~ 10%), systolic blood pressure (~ 8%), and diastolic blood pressure (~ 9%). In DA, only LDL-C decreased (~ 10%, P < 0.05). Significant increases were found in PI (P < 0.05) for total cholesterol (~ 15%), LDL-C (~ 12%), triglycerides (~ 15%), and systolic blood pressure (~ 5%). FRS lowered 35% in FA (intention-to-treat, P < 0.05), remained stable in DA (P > 0.05), and increased by 20% in PI (P < 0.05).ConclusionsA supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources.Trial registrationTCTR20181221002 (retrospectively registered). Registered December 21, 2018.

GW27-e0412 Prevalence of hypertension and risk assessment of cardiovascular disease in community 35∼59 aged hypertensive patients in Shenzhen City

To understand the status of hypertensive patients, the status of the cardiovascular disease (CVD) related risk factors, and the evaluate risk of ischemic cardiovascular diseases (ICVD) in the next decade among the community hypertensive patients in Shenzhen, and to provide a scientific basis for

Prevalence of prehypertension and its relationship to risk factors for cardiovascular disease in community of Chengdu

Objective: In this paper we estimate the prevalence of prehypertension in community of Chengdu and evaluate the relationship between prehypertension and other risk factors for CVD and multiple metabolic disorders. Methods: The study used data from participants of three communities in Chengdu. A sample of 3524 persons, aged 18 years and over, completed an interviewer administered questionnaire and blood pressure measurements, physical examination and blood samples were obtained and analyzed for all individuals. Results: (1) The prevalence of prehypertension in Chengdu was 34.07% and increased with age up to 30–39 (39.93%) and then declined in the older age groups. Prehypertension was more common in males than females (41.16% vs 23.89%, P<0.05). (2) Prevalence of some cardiovascular risk factors in prehypertensives was significantly higher than that in normotensives (P<0.05). (3) Odds of hyperglycemia, increased fasting blood glucose, hyperuricemia and obesity, overweight, and increased waist circumference were significantly higher among prehypertensive participants when compared to normotensive participants. Conclusions: Prehypertension occurs in 34.07% of Chengdu and is associated with increased prevalence of other CVD risk factors. Health-care providers should recognize the increased CVD risk of prehypertension and should seek to identify and treat modifiable risk factors in these persons.

Knowledge, attitudes and cardiovascular risk factors in Danish adults.

A community cardiovascular disease (CVD) prevention programme was undertaken in 1989 in a Danish County (Vejle). A random sample of 5192 adults were asked to complete a mailed questionnaire on knowledge, attitudes, and behaviour in relation to CVD risk factors. The response rate was 56%. The questionnaire produced baseline data for programme planning and measuring the success of on-going interventions. Smoking, overweight, and unhealthy food habits were the most prevalent CVD risk factors. A CVD risk score was calculated from the data on smoking, food habits, exercise, stress, overweight, self-reported presence of hypertension, diabetes, and gender. A high score was commoner in men, in the least educated, in groups who judged their own risk as high, and in groups with negative health beliefs. The level of knowledge about CVD risk factors was high in general. Low knowledge was commonest in the youngest age group, in the least educated, in unskilled workers, and in groups with negative health beliefs. As social position and personality factors seem to play an important role in actions people may take in prevention of CVD, they should be considered in the planning of the health promotion activities in Vejle.

Community surveillance for cardiovascular disease. Methods, problems, applications—A review

The increasing interest in utilization of surveillance for determining incidence of cardiovascular disease in communities prompted a reassessment of the state-of-the-art of this methodology. A literature review revealed that most studies identified at least 200 cases of the target disease(s) from populations of > 60,000. Hospital and death records predominated as data sources for case finding and validation of diagnoses. Personnel requirements, when reported, were modest. The practical components of community surveillance methodology are (1) feasibility. (2) community ground work, (3) diagnostic criteria, (4) case finding, (5) case validation, (6) data reduction and analysis. Methods, problems, pitfalls and costs of each are discussed together with suggested applications and future research and development of surveillance methodology.