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Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease

BECKER, Diane M ; YANEK, Lisa R ; JOHNSON, Wallace R ; GARRETT, Diane ; MOY, Taryn F ; REYNOLDS, Stasia Stott ; BLUMENTHAL, Roger S ; VAIDYA, Dhananjay ; BECKER, Lewis C

Circulation (New York, N.Y.), 2005-03, Vol.111 (10), p.1298-1304 [Periódico revisado por pares]

Hagerstown, MD: Lippincott Williams & Wilkins

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Título:
Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease
Autor: BECKER, Diane M ; YANEK, Lisa R ; JOHNSON, Wallace R ; GARRETT, Diane ; MOY, Taryn F ; REYNOLDS, Stasia Stott ; BLUMENTHAL, Roger S ; VAIDYA, Dhananjay ; BECKER, Lewis C
Assuntos: Adult ; African Americans - statistics & numerical data ; Antihypertensive Agents - therapeutic use ; Atherosclerosis (general aspects, experimental research) ; Baltimore - epidemiology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cholesterol, LDL - blood ; Communication Barriers ; Community Health Nursing ; Community Health Services ; Community Health Workers ; Community-Institutional Relations ; Coronary Disease - ethnology ; Coronary Disease - genetics ; Coronary Disease - nursing ; Coronary Disease - prevention & control ; Coronary heart disease ; Diabetes Mellitus - diagnosis ; Diabetes Mellitus - ethnology ; Diet ; Disease Susceptibility ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Exercise ; Family Health ; Female ; Heart ; Humans ; Hypercholesterolemia - blood ; Hypercholesterolemia - diagnosis ; Hypercholesterolemia - ethnology ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - ethnology ; Male ; Medical sciences ; Middle Aged ; Nurse Practitioners ; Primary Health Care - methods ; Risk ; Siblings ; Smoking - epidemiology ; Smoking - ethnology ; Smoking Cessation ; Surveys and Questionnaires ; Treatment Outcome
É parte de: Circulation (New York, N.Y.), 2005-03, Vol.111 (10), p.1298-1304
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-News-3
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Descrição: Black subjects with a family history of premature coronary heart disease (CHD) have a marked excess risk, yet barriers prevent effective risk reduction. We tested a community-based multiple risk factor intervention (community-based care [CBC]) and compared it with "enhanced" primary care (EPC) to reduce CHD risk in high-risk black families. Black 30- to 59-year-old siblings of a proband with CHD aged <60 years were randomized for care of BP > or =140/90 mm Hg, LDL cholesterol > or =3.37 mmol/L, or current smoking to EPC (n=168) or CBC (n=196) and monitored for 1 year. EPC and CBC were designed to eliminate barriers to care. The CBC group received care by a nurse practitioner and a community health worker in a community setting. The CBC group was 2 times more likely to achieve goal levels of LDL cholesterol and blood pressure compared with the EPC group (95% CI, 1.11 to 4.20 and 1.39 to 3.88, respectively) with adjustment for baseline levels of age, sex, education, and baseline use of medications. The CBC group demonstrated a significant reduction in global CHD risk, whereas no reduction was seen in the EPC group (P<0.0001). Eliminating known barriers may not be sufficient to reduce CHD risk in primary care settings. An alternative community care model that addresses barriers may be a more effective way to ameliorate CHD risk in high-risk black families.
Editor: Hagerstown, MD: Lippincott Williams & Wilkins
Idioma: Inglês

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Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease

BECKER, Diane M ; YANEK, Lisa R ; JOHNSON, Wallace R ; GARRETT, Diane ; MOY, Taryn F ; REYNOLDS, Stasia Stott ; BLUMENTHAL, Roger S ; VAIDYA, Dhananjay ; BECKER, Lewis C

Hagerstown, MD: Lippincott Williams & Wilkins

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