Dataset Information

Factors Influencing Physician Counseling on Cardiovascular Risk.

ABSTRACT:

Background and importance

A significant reduction in cardiovascular disease (CVD) mortality is related to aggressive management of modifiable CVD risk factors. Therefore, patients at increased risk for CVD should not only benefit from standard pharmacotherapy but also from counseling regarding lifestyle behavioral changes.

Objective

To determine the patient factors that influence provision of cardiovascular risk reduction counseling from physicians, as well as the frequencies of counseling.

Design, setting, and participants

Secondary analysis of a prospective, randomized trial among an underserved inner-city and rural population (n = 388) with a 10% or greater CVD risk (Framingham 10-year risk score). Subjects were followed for 1 year and were seen for quarterly assessments, which included evaluation of weight, blood pressure, lipid, and glucose status. At each of the 4 quarterly visits, subjects were asked if their physician had discussed or made recommendations regarding lifestyle behaviors, specifically diet, weight loss, and exercise.

Results

The average patient age was 61.3 ± 10.1 years, average A1c was 6.7 ± 1.6%, average total cholesterol was 201 ± 44 mg/dL. The average body mass index (BMI) was 31.8 ± 6.4 kg/m2, and the average blood pressure was 146 ± 18/82 ±11 mm Hg. Using binary logistic regression analysis, BMI (P < .025) was the only clinical factor related to physician lifestyle counseling. All other risk factors showed no statistical relationship.

Conclusion

The data indicate that BMI is the major factor associated with whether or not physicians provide counseling regarding nutrition and weight loss. Physicians may be missing important opportunities to influence behavior in patients at high risk for CVD by limiting their focus to obese patients.

SUBMITTER: Rakita V

PROVIDER: S-EPMC5932710 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Factors Influencing Physician Counseling on Cardiovascular Risk.

Rakita Val V Homko Carol J CJ Kashem Abul A Memon Nabeel N Bove Alfred A AA

Journal of primary care & community health 20151116 2

<h4>Background and importance</h4>A significant reduction in cardiovascular disease (CVD) mortality is related to aggressive management of modifiable CVD risk factors. Therefore, patients at increased risk for CVD should not only benefit from standard pharmacotherapy but also from counseling regarding lifestyle behavioral changes.<h4>Objective</h4>To determine the patient factors that influence provision of cardiovascular risk reduction counseling from physicians, as well as the frequencies of c ...[more]

PMID: 26574567

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Project description:ImportanceChanges in dietary habits and lifestyle can reduce the risk of cardiovascular disease which is the leading cause of death worldwide. Objectives of the MoKaRi study The MoKaRi (modulation of cardiovascular risk factors) intervention study is designed to evaluate the effectiveness and potential of the developed MoKaRi concept. The MoKaRi concept comprises three components, each designed to improve dietary behavior. The first component entails using daily menu plans to implement a defined "cardioprotective diet". This diet consists of seasonal menu plans which are characterized by:(i) a personalized energy supply depending on his or her age, gender, level of physical activity.(ii) an adequate intake of carbohydrates, protein, fat, vitamins, minerals, and trace elements according to the guidelines of the German Society of Nutrition (DGE).(iii) a recommended intake of saturated fatty acids (SFA; < 7% of caloric intake (En%)), monounsaturated fatty acids (MUFA; > 10 En%), polyunsaturated fatty acids.(PUFA; approx. 10 En%), and long-chain n-3 PUFA (≥500 mg per day).(iv) measures to encourage consumption of vegetables and fruits, and.(v) eating more than 40 g dietary fiber every day.Half of the participants will be scheduled to consume an additional 3 g of long-chain n- 3 PUFA every day in the form of fish oil.The second component consists of regular one-on-one nutritional counseling, while a variety of further incentives make up the third component of the MoKaRi concept.The MoKaRi study will provide essential insights into the relationship between defined nutrient intake, markers of food intake and health status. Our specific aim is to investigate the influence of dietary and lifestyle choices have on cardiovascular health.The information and practical tools suitable for daily use, such as the personalized menu plans, could help to transfer knowledge on nutritional facts to the general population. In this way, the validated MoKaRi concept may contribute to the prevention and therapy of cardiovascular diseases.MethodsIn line with our power calculation, we will enroll 60 participants and randomly assign them to one of two parallel arms. Each participant will receive personalized menu plans for each day of the study and will be provided with one-on-one nutritional counseling sessions every two weeks for a study period of 20 weeks (140 days). During this period, blood samples will be taken every 14 days (11 time points) and twice during a 20-weeks follow-up period. Incentives such as a supply of foods approved according t the standards of the study, a sports program, individual feedback on study parameters reflecting health status, and group activities round off the MoKaRi concept.Low-density cholesterol is the primary outcome measure of the MoKaRi study, and the secondary endpoints comprise markers of nutrient status (e.g. fatty acid distribution in plasma and erythrocyte lipids), a metabolomic profiling, diabetes risk markers, clotting markers, and further cardiovascular risk factors, such as blood lipids, homocysteine and high-sensitive c-reactive protein.The MoKaRi study was registered before launch at ClinicalTrials.gov (identifier NCT02637778; https://clinicaltrials.gov/ct2/show/NCT02637778).

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Dataset Information

Factors Influencing Physician Counseling on Cardiovascular Risk.

Background and importance

Objective

Design, setting, and participants

Results

Conclusion

Publications

Factors Influencing Physician Counseling on Cardiovascular Risk.

Similar Datasets

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