Physical training program for people at risk of cardiovascular disorders in the primary care setting: A randomized clinical trial

Background and Objective: The impact of a physical training program on moderate–vigorous physical activity is still poorly known in primary cardiovascular prevention. Our objective was to determine the efficacy of a physical training program to promote moderate–vigorous physical activity and exercise in individuals at risk of suffering a cardiovascular event.Patients and methodsRandomized, parallel group controlled trial performed from October 2014 to July 2016. Sedentary patients at risk of suffering a cardiovascular event were randomized to the control group (CG) (72) or the intervention group (IG) (75). Intervention consisted of a 2-month physical training program. The main outcome was the proportion of patients achieving a “relevant response to Physical Activity” (increase≥240METs-min/week in moderate–vigorous Physical Activity using the International Physical Activity Questionnaire (IPAQ)). Secondary outcomes included the proportion of patients performing an “adequate amount of exercise” (≥360METs-min/week in moderate–vigorous exercise using the IPAQ).ResultsOf the 147 patients randomized, 132 (90%) completed the follow-up. Adherence to exercise performance was 91% and no adverse effects were recorded. The proportion of patients in the IG versus CG achieving the main outcome was 34.9% vs 11.6%; OR [95%CI]: 4.2 [1.7–10.4]. Furthermore, more patients in the IG performed an adequate amount of exercise (33.3% vs. 11.6%; OR: 4.1 [1.6–10.5]).ConclusionA short-duration physical training program performed in the primary care setting is efficacious and safe in promoting moderate–vigorous physical activity and exercise in the short-term, in a population at risk of suffering a cardiovascular event. (AU)

Antecedentes y objetivo: El impacto de programas de entrenamiento en actividad física moderada-vigorosa es poco conocido en prevención primaria cardiovascular. Nuestro objetivo fue analizar la eficacia de un programa de entrenamiento en promover la actividad física moderada-vigorosa y la práctica de ejercicio, en pacientes con riesgo de eventos cardiovasculares.Pacientes y métodoEnsayo clínico aleatorizado, paralelo, con grupo control (octubre 2014 a julio 2016). Pacientes sedentarios con riesgo de eventos cardiovasculares se aleatorizaron a un grupo control (GC) (72) o un grupo intervención (GI) (75). La intervención consistió en un programa de entrenamiento de 2meses. La variable pronóstica principal fue la proporción de pacientes que alcanzaron una «respuesta relevante en actividad física» (aumento≥240MET-min/sem actividad física moderada-vigorosa en el Cuestionario Internacional de Actividad Física [International Physical Activity Questionnaire, IPAQ]). Las variables pronósticas secundarias incluyeron la proporción de pacientes que realizaban una «adecuada cantidad de ejercicio»(≥360MET-min/sem ejercicio moderado-vigoroso en el IPAQ).ResultadosDe los 147 pacientes aleatorizados, 132 (90%) completaron el seguimiento. La adherencia a las sesiones fue del 91% y no se registraron efectos adversos. La proporción de pacientes en GI versus GC que alcanzaron el objetivo principal fue del 34,9% vs el 11,6%; OR: 4,2; IC 95%: 1,7-10,4. Significativamente más pacientes en el GI realizaron una adecuada cantidad de ejercicio (33,3% vs 11,6%; OR: 4,1; IC 95%: 1,6-10,5).ConclusiónUn programa de entrenamiento de corta duración realizado en atención primaria es eficaz y seguro a corto plazo en la promoción de la actividad física moderada-vigorosa y del ejercicio en una población con riesgo de eventos cardiovasculares. (AU)

Physical training program for people at risk of cardiovascular disorders in the primary care setting: A randomized clinical trial.

BACKGROUND AND OBJECTIVE: The impact of a physical training program on moderate-vigorous physical activity is still poorly known in primary cardiovascular prevention. Our objective was to determine the efficacy of a physical training program to promote moderate-vigorous physical activity and exercise in individuals at risk of suffering a cardiovascular event. PATIENTS AND METHODS: Randomized, parallel group controlled trial performed from October 2014 to July 2016. Sedentary patients at risk of suffering a cardiovascular event were randomized to the control group (CG) (72) or the intervention group (IG) (75). Intervention consisted of a 2-month physical training program. The main outcome was the proportion of patients achieving a "relevant response to Physical Activity" (increase≥240METs-min/week in moderate-vigorous Physical Activity using the International Physical Activity Questionnaire (IPAQ)). Secondary outcomes included the proportion of patients performing an "adequate amount of exercise" (≥360METs-min/week in moderate-vigorous exercise using the IPAQ). RESULTS: Of the 147 patients randomized, 132 (90%) completed the follow-up. Adherence to exercise performance was 91% and no adverse effects were recorded. The proportion of patients in the IG versus CG achieving the main outcome was 34.9% vs 11.6%; OR [95%CI]: 4.2 [1.7-10.4]. Furthermore, more patients in the IG performed an adequate amount of exercise (33.3% vs. 11.6%; OR: 4.1 [1.6-10.5]). CONCLUSION: A short-duration physical training program performed in the primary care setting is efficacious and safe in promoting moderate-vigorous physical activity and exercise in the short-term, in a population at risk of suffering a cardiovascular event. TRIAL REGISTRATION: "Training Programme in Physical Activity". NCT03717363. TRIAL REGISTRATION: Clinicaltrials.gov.

Prevalencia de hipertensión arterial y otros factores de riesgo cardiovascular en la población con hipotiroidismo subclínico / Prevalence of hypertension and other cardiovascular risk factors in subjects with subclinical hypothyroidism

Fundamento y objetivo: Determinar la prevalencia de hipertensión arterial, así como de diabetes y dislipidemia en el hipotiroidismo subclínico (HS), comparado con un grupo control de la misma edad y sexo. Pacientes y método: Estudio de casos (HS) (N=240) y controles (N=480) realizado en un Centro de Atención Primaria en individuos entre 35 y 75 años. Se evaluó la presencia de hipertensión arterial, diabetes y dislipidemia, así como las cifras de presión arterial, perfil lipídico y glucemia en ayunas. Resultados: No se observaron diferencias entre casos y controles en la prevalencia de hipertensión arterial (34,2 vs. 29,6%) o de diabetes (12,1 vs. 10%), ni en los valores de presión arterial o de glucemia en ayunas. Los pacientes con HS presentaron con mayor frecuencia dislipidemia (72,1 vs. 57,7%; p<0,001) así como cifras más elevadas de colesterol total (205±34 vs. 193±35mg/dl; p<0,001), con respecto a los controles. Conclusiones: Los pacientes con HS presentan una prevalencia elevada de trastornos lipídicos, sin diferencias significativas en hipertensión arterial o diabetes. Ello muestra la presencia de un riesgo cardiovascular incrementado en dicha población (AU)

Background and objective: To assess the prevalence of hypertension, diabetes, and dyslipidaemia in subjects with subclinical hypothyroidism (SH) in comparison with an age- and sex-matched control group. Patients and methods: Case-control study with 240 subjects with SH and 480 controls carried out on patients aged 35-75 years admitted to a Primary Care Centre. The prevalence of hypertension, diabetes and dyslipidaemia, as well as blood pressure, plasma glucose, and lipid profilses, were evaluated in both groups. Results: No differences were observed neither in the prevalence of hypertension (34.2% vs. 29.6%) or diabetes (12.1% vs. 10%) nor in mean values of blood pressure or plasma fasting glucose. Subjects with SH had an increased prevalence of lipid abnormalities (72.1% vs. 57.7%; P<.001), and increased mean values of total cholesterol (205±34 vs. 193±35mg/dL; P<.001), compared to the control group. Conclusion: Patients with SH have an increased prevalence of lipid abnormalities. This can be responsible for an increased cardiovascular risk in such patients (AU)

Prevalence of hypertension and other cardiovascular risk factors in subjects with subclinical hypothyroidism. / Prevalencia de hipertensión arterial y otros factores de riesgo cardiovascular en la población con hipotiroidismo subclínico.

BACKGROUND AND OBJECTIVE: To assess the prevalence of hypertension, diabetes, and dyslipidaemia in subjects with subclinical hypothyroidism (SH) in comparison with an age- and sex-matched control group. PATIENTS AND METHODS: Case-control study with 240 subjects with SH and 480 controls carried out on patients aged 35-75 years admitted to a Primary Care Centre. The prevalence of hypertension, diabetes and dyslipidaemia, as well as blood pressure, plasma glucose, and lipid profilses, were evaluated in both groups. RESULTS: No differences were observed neither in the prevalence of hypertension (34.2% vs. 29.6%) or diabetes (12.1% vs. 10%) nor in mean values of blood pressure or plasma fasting glucose. Subjects with SH had an increased prevalence of lipid abnormalities (72.1% vs. 57.7%; P<.001), and increased mean values of total cholesterol (205±34 vs. 193±35mg/dL; P<.001), compared to the control group. CONCLUSION: Patients with SH have an increased prevalence of lipid abnormalities. This can be responsible for an increased cardiovascular risk in such patients.