Prevention of cardiovascular disease in a rural general practice
Elżbieta Tomiak 1, Sławomir Chlabicz 2, Elżbieta Mizgała 3, Witold Lukas 4, Lech Panasiuk 5, Witold Drzastwa 6, Agnieszka Jankowska-Zduńczyk 7 1 - VITA Team Doctor Family, Training Centre of Family Physicians in Otyniu, Poland 2 - Department of Family Medicine and Community Nursing, Medical University of Bialystok, Poland 3 - Department of Family Medicine in Zabrze, Medical University of Silesia in Katowice, Poland 4 - Department of Public Health, Faculty of Management, University of Czestochowa, Poland 5 - Department of Internal Medicine, Hypertension and Occupational Diseases Rural Medicine Institute in Lublin, Poland 6 - Department of Family Medicine in Zabrze, Medical University of Silesia in Katowice, Poland 7 - Specialist Medical Practice in Warsaw, Poland Ann Agric Environ Med 2016; 23 (4): ICID: 1226845 Article type: Original article
Introduction. Cardiovascular disease (CVD) prophylaxis in general practice, especially in rural areas, is a major organizational challenge. Objective. The aim of this study was to determine the prevalence of CVD risk factors in the studied population, and to identify the effect of the number of planned prophylactic consultations on selected clinical parameters, risk factors, and total cardiovascular risk on the SCORE scale (Systemic Coronary Risk Evaluation). Materials and method. The study included patients of a rural general practice, aged 35–55 years, with at least one modifiable CVD risk factor. Medical history was obtained, a physical examination performed, blood glucose levels, lipid profile, BMI, waist circumference and blood pressure measured and the SCORE cardiovascular risk at baseline and at the end of the study calculated. All participants were provided with targeted specific education. Analysis was performed in two groups of patients (1 and 2), where group 1 had one more prophylactic consultation than Group 2. Results. The results at baseline and a year later were compared in pharmacologically untreated patients, 26 in Group 1 and 34 in Group 2. In Group 1, which had had more prophylactic consultations, a statistically significant decrease was found in the mean systolic blood pressure: 131.000–124.782 (p= 0.02721), mean diastolic blood pressure: 86.846–83.462 (p=0.01111), and a statistically significant decrease in total cardiovascular risk on the SCORE scale (p=0.0478). Conclusions. The higher number of preventive consultations had an impact on a statistically significant decrease in mean blood pressure and mean SCORE value. The year-long cardiovascular disease prophylaxis programme proved less effective than expected, and neither a decrease in body weight nor an improvement in lipid metabolism was achieved in any of the groups.
DOI: 10.5604/12321966.1226845 PMID 28030922 - click here to show this article in PubMed