Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial

Abstract Background Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18–50) visiting their fami...

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Autores principales:	Liina Kask-Flight, Koray Durak, Kadri Suija, Anneli Rätsep, Ruth Kalda
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Hypertension Decision aid Cardiovascular risk Shared decision making Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/aa0164d27dfb4a6e898eefa897193b7f
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spelling	oai:doaj.org-article:aa0164d27dfb4a6e898eefa897193b7f2021-11-21T12:04:08ZReduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial10.1186/s12872-021-02339-11471-2261https://doaj.org/article/aa0164d27dfb4a6e898eefa897193b7f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02339-1https://doaj.org/toc/1471-2261Abstract Background Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18–50) visiting their family doctor (FD) and to find out if using an interactive computer-based decision aid (DA) has advantages in reducing cardiovascular risk factors compared to usual counselling at the FD’s office. Methods The study was a cluster-randomized controlled trial including hypertensive male patients aged 18–50 recruited by their FD in 2015–2016. Patients with cardiovascular complications were not included. FDs were randomly divided into intervention groups (n = 9) and control groups (n = 11). Altogether, FDs recruited 130 patients, 77 into the intervention group (IG) and 53 into the control group (CG). IG patients were counselled about cardiovascular risk factors using a computer-based DA. CG patients received usual counselling by their FD. Data was collected with questionnaires, clinical examinations and laboratory analyses at the baseline and at the follow-up visit three months later. We compared the cardiovascular risk factors of the IG and CG patients. Results Baseline characteristics of the IG and CG patients were comparable. Of the whole study group, 51.5% (n = 67) of the patients had hypertension grade 1, 45.4% (n = 59) had grade 2 and 3.1% (n = 4) had grade 3. Twenty-seven per cent (n = 21) of the IG and 42% (n = 22) of the CG patients were smokers. We found that shared decision making with the DA was more effective in smoking reduction compared to usual FD counselling: 21 smoking patients in the IG reduced the number of cigarettes per day which is significantly more than the 22 smoking patients in the CG (− 3.82 ± 1.32 (SE Mean) versus + 2.32 ± 1.29; p = 0.001). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the number of cigarettes per day, all showed a statistically significant reduction among patients who were using the DA. Male patients with hypertension grade 2 had a significantly greater reduction in their SBP (− 6.003 ± 2.59 (SE Mean) versus + 1.86 ± 2.58; p = 0.038) grade 1. Reduction of DBP, cigarettes per day and CVD risk in general were nearly significant in the IG whereas the CG showed an increase in all of these parameters. Conclusion Using interactive DAs at FD’s offices for counselling of young hypertensive male patients is one possibility to help patients understand their risk factors and make changes in their treatment choices. DAs can be more effective in achieving behavioural changes like reducing smoking or blood pressure compared to normal counselling.Liina Kask-FlightKoray DurakKadri SuijaAnneli RätsepRuth KaldaBMCarticleHypertensionDecision aidCardiovascular riskShared decision makingDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hypertension Decision aid Cardiovascular risk Shared decision making Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Hypertension Decision aid Cardiovascular risk Shared decision making Diseases of the circulatory (Cardiovascular) system RC666-701 Liina Kask-Flight Koray Durak Kadri Suija Anneli Rätsep Ruth Kalda Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
description	Abstract Background Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18–50) visiting their family doctor (FD) and to find out if using an interactive computer-based decision aid (DA) has advantages in reducing cardiovascular risk factors compared to usual counselling at the FD’s office. Methods The study was a cluster-randomized controlled trial including hypertensive male patients aged 18–50 recruited by their FD in 2015–2016. Patients with cardiovascular complications were not included. FDs were randomly divided into intervention groups (n = 9) and control groups (n = 11). Altogether, FDs recruited 130 patients, 77 into the intervention group (IG) and 53 into the control group (CG). IG patients were counselled about cardiovascular risk factors using a computer-based DA. CG patients received usual counselling by their FD. Data was collected with questionnaires, clinical examinations and laboratory analyses at the baseline and at the follow-up visit three months later. We compared the cardiovascular risk factors of the IG and CG patients. Results Baseline characteristics of the IG and CG patients were comparable. Of the whole study group, 51.5% (n = 67) of the patients had hypertension grade 1, 45.4% (n = 59) had grade 2 and 3.1% (n = 4) had grade 3. Twenty-seven per cent (n = 21) of the IG and 42% (n = 22) of the CG patients were smokers. We found that shared decision making with the DA was more effective in smoking reduction compared to usual FD counselling: 21 smoking patients in the IG reduced the number of cigarettes per day which is significantly more than the 22 smoking patients in the CG (− 3.82 ± 1.32 (SE Mean) versus + 2.32 ± 1.29; p = 0.001). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the number of cigarettes per day, all showed a statistically significant reduction among patients who were using the DA. Male patients with hypertension grade 2 had a significantly greater reduction in their SBP (− 6.003 ± 2.59 (SE Mean) versus + 1.86 ± 2.58; p = 0.038) grade 1. Reduction of DBP, cigarettes per day and CVD risk in general were nearly significant in the IG whereas the CG showed an increase in all of these parameters. Conclusion Using interactive DAs at FD’s offices for counselling of young hypertensive male patients is one possibility to help patients understand their risk factors and make changes in their treatment choices. DAs can be more effective in achieving behavioural changes like reducing smoking or blood pressure compared to normal counselling.
format	article
author	Liina Kask-Flight Koray Durak Kadri Suija Anneli Rätsep Ruth Kalda
author_facet	Liina Kask-Flight Koray Durak Kadri Suija Anneli Rätsep Ruth Kalda
author_sort	Liina Kask-Flight
title	Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
title_short	Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
title_full	Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
title_fullStr	Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
title_full_unstemmed	Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
title_sort	reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
publisher	BMC
publishDate	2021
url	https://doaj.org/article/aa0164d27dfb4a6e898eefa897193b7f
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Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial

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