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Preventive Counselling With the Use of Remote Technologies Provides Effective Control of Metabolic Risk Factors in Patients With High and Very High Cardiovascular Risk

https://doi.org/10.18087/cardio.2018.10.10183

Abstract

Purpose: to assess the impact of preventive counseling with focus on diet modification on lipid and metabolic parameters in patients with high/very high cardiovascular (CV) risk who visited Health centers. Materials and methods. This was a prospective randomized controlled study of patients aged 40 to 65 years with high/very high CV risk (≥5% according to the Systematic Coronary Risk Evaluation scale [SCORE]) and any 2 criteria for metabolic syndrome. Patients were 1:1 randomized into 2 groups. The intervention group (n=50) received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group (n=50) received usual care in Health centers which also included basic preventive counseling. Results. A total of 100 patients (women 82%, age 59.74±4.66 years) were randomized. At baseline 81% of patients had high and 19% - very high CV risk. The groups were well balanced according to demographic and clinical features. At 1 year of follow-up patients from the intervention group experienced significant improvement of metabolic parameters compared with controls: their diastolic blood pressure (BP) decreased by 5.62±7.7 mm Hg, total and low-density lipoprotein cholesterol (TC and LDL-C) - by 0.5±0.83 and 0.46±0.62 mmol/l, respectively. Both groups experienced statistically and clinically significant decreases in systolic BP (intervention, - 17.76±16.2 mm Hg, control, - 13.44±15.6 mm Hg; both groups p<0.001). Nevertheless, the difference between groups at 1 year was not significant. Also, patients from the intervention group vs controls experienced significant improvement of adiposity parameters: their weight decreased by 2.43 ± 2.74 kg, body mass index - by 0.9±0. 99 kg/m2, waist circumference - by 1.96±3.2 cm, and height-normalized body fat mass (according to bioimpedance) - by 1.63 ± 2.3%. Conclusion: Preventive counseling with focus on diet modification followed by 3 months remote support by phone provided significant improvement of metabolic and lipid parameters.

About the Authors

N. V. Pogosova
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


Yu. M. Yufereva
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


A. I. Yusubova
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


A. M. Allenov
City polyclinic № 210
Russian Federation


A. V. Karpova
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


A. K. Ausheva
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


A. V. Pogozheva
FITS Nutrition and Biotechnology
Russian Federation


R. A. Eganyan
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


V. A. Vygodin
Federal State Institution National Research Center for Preventive Medicine
Russian Federation


References

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Review

For citations:


Pogosova N.V., Yufereva Yu.M., Yusubova A.I., Allenov A.M., Karpova A.V., Ausheva A.K., Pogozheva A.V., Eganyan R.A., Vygodin V.A. Preventive Counselling With the Use of Remote Technologies Provides Effective Control of Metabolic Risk Factors in Patients With High and Very High Cardiovascular Risk. Kardiologiia. 2018;58(10):34-44. (In Russ.) https://doi.org/10.18087/cardio.2018.10.10183

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ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)