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Multicenter Study
. 2001 Dec;28(10):642-7.
doi: 10.1016/s0212-6567(01)70477-5.

[Effectiveness of cardiovascular prevention in primary care]

[Article in Spanish]
F Antón García  1 , A Maiques Galán, M Franch Taix, E Aleixandre Martí, A B Gómez Ortega, R Sotoca Cobaleda
Affiliations
Multicenter Study

[Effectiveness of cardiovascular prevention in primary care]

[Article in Spanish]
F Antón García et al. Aten Primaria. 2001 Dec.

Abstract
in English, Spanish

Objectives: To evaluate the modification of risk factors and of coronary risk (CR) in adults (14-75 years old) after a period of 1 to 5 years in the PAPPS (special prevention programme).

Design: Multi-centre intervention study with no before-and-after random allocation.

Setting: Primary care.

Participants: Patients included in the PAPPS at 3 health centres, 634 monitored for five years, 890 for four years, 1605 for 3 years and 2829 for 2 years, were evaluated.Interventions. Minimum counselling to give up tobacco and over-consumption of alcohol, and educational and pharmacological measures to reduce cholesterol and blood pressure.

Main measurements: Recording of blood pressure, cholesterol, weight, and tobacco and alcohol consumption. CR was determined in the sub-group of 30-75 years old. These variables were determined at the start and end of the various monitoring periods.

Results: CR was reduced by between 0.2 and 0.3%; systolic blood pressure, by between 0.4 and 0.9 mmHg; diastolic pressure, by between 0.3 and 0.7 mmHg; cholesterol, by between 0.5 and 2.5 mg/dl; percentage of smokers, by between 0.3 and 2.8%; and over-consumption of alcohol, by between 0.2 and 1%.

Conclusions: Scant success of the interventions to reduce CR and risk factors in the population as a whole. The main use of cardiovascular prevention programmes with many factors resides in detecting high-risk patients for subsequent intervention.

Objetivos: Evaluar la modificación de los factores de riesgo y del riesgo coronario en adultos (14–75 años) tras un período de entre 1 y 5 años de ser incluidos en el PAPPS.

Diseño: Estudio multicéntrico de intervención sin asignación aleatoria antesdespués.

Emplazamiento: Atención primaria

Participantes: Se evalúa a los pacientes incluidos en el PAPPS de 3 centros salud, 634 seguidos durante 5 años, 890 durante 4 años, 1.605 durante 3 años y 2.829 durante 2 años.

Intervenciones: Consejo mínimo para abandonar tabaco y consumo excesivo de alcohol, medidas educacionales y farmacológicas para reducir colesterol y presión arterial.

Mediciones principales: Toma de la presión arterial, colesterol, peso, consumo tabaco y alcohol. En el subgrupo 30–75 años determinación del riesgo coronario. Estas variables se determinaron al inicio y al final de los distintos períodos de seguimiento.

Resultados: La reducción del riesgo coronario fue entre el 0,2 y el 0,3%, de la presión arterial sistólica entre 0,4 y 0,9 mmHg, y de la diastólica entre 0,3 y 0,7 mmHg, del colesterol entre 0,5 y 2,5 mg/dl, del porcentaje de fumadores entre el 0,3 y el 2,8% y del consumo excesivo de alcohol entre el 0,2 y el 1%.

Conclusiones: Escasa repercusión de las intervenciones realizadas para reducir el riesgo coronario o los factores de riesgo en la población total. La utilidad principal de los programas de prevención cardiovascular y multifactoriales estribaría en la detección de los pacientes de alto riesgo para, posteriormente, intervenir sobre ellos.

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