| BackgroundWith the improvement of social life and the accelerated pace of work, people's ways of life have made major changes. Cardiovascular diseases, as the representative of chronic diseases, are increasing. According to the 2002 Qingdao residents'nutrition and health survey, the city's residents are cardiovascular risk factors. The incidence of coronary heart disease, list first in the country, has obvious geographical characteristics.High incidence of cardiovascular disease, high morbidity and high mortality cost heavy burden to society and city residents, has become a major public health problem.Large epidemiological studies have shown that the level of cardiovascular risk factors continues to rise is the main reason of for consistent high incidence of cardiovascular disease. The main risk factors are hypertension, smoking, high cholesterol, glucose level abnormal, overweight/obesity and physical inactivity. Interheart study found that 8 of known cardiovascular risk factors controlled predict individual risk of future myocardial infarction was 90%certainty, These studies provide evidence that, intervention can be effective through reducing the risk factors of cardiovascular disease.Primary prevention and early intervention have become major strategies and effective way for the control of the epidemic of cardiovascular diseases. However, the current intervention in the relevant risk factors for the implementation of guidelines and expert consensus is concerned, there is confusion as follows:1, the comparison of the difference between slightly increased in a number of risk factors for individual risk factors with a single high-level; 2, the comparison of the difference between different combinations of risk factors with the intensity cardiovascular disease; 3, how to improve the compliance of individualized intervention in different populations; 4, the methods to standardize the coexistence of multiple risk factors intervention.Therefore, through the rational experimental study in groups, the correct use of statistical methods to analyze the distribution characteristics of the risk of cardiovascular disease risk factors, and explore effective interventions for prevention of cardiovascular events, reduce the higher incidence of the disease has significant practical value.OBJECTIVES1, Describes the population aged 35-64 in northern coastal areas, coronary heart disease and cardiovascular disease in patients with high risk of exposure to risk factors, and analyzes the individual clustering of risk factors.2, Compares the effectiveness of simple life style intervention with comprehensive intervention; observes the trend of intervention targets; explores simple and effective intervention measures.3, And explores the intervention sensitive indicator when coexistence of multiple risk factors, analyzes the mechanism and influence factors.MethodsIn 2007-2009, from the Health Examination Center of Qingdao Municipal Hospital medical objects selected 312 cases with over one risk factor for cardiovascular disease as risk factors patients (Risk Factor RF) group. From specialist outpatient and hospital inpatient, in accordance with "coronary heart disease (ischemic heart disease) diagnostic criteria", selected 282 cases of patients with the clinical coronary angiography and/or confirmed coronary heart disease coronary intravascular ultrasound (Coronary heart disease CHD) as control group. Two groups based on the implementation of the intervention and non-intervention condition were randomly divided into four subgroups, namely, intervention in risk factors (RF-I) and observation (RF-C) group, coronary intervention (CHD-I) and observation (CHD-C group). Group RF-I based on lifestyle intervention, Group CHD-I used integrated interventions (lifestyle+drug intervention), intervention as a balanced diet, smoking cessation, weight control, regular exercise, etc. Intervention duration is 14 months, evaluation were carried out at 3,6 and 14 months, respectively. Evaluation of the control group, including:general project:physical activities, smoking status and smoking cessation, drug application and drug laws. Detection indicators include:TC, TG, glucose disord (GD), LDL-C, apolipoprotein a (Lpa), waist circumference (WL), body mass index (BMI), carotid artery intima thickness (IMT); blood pressure and compliance rate.After sorting data, databases were created and statistical analysis were carried out through SPSS 12.0. Frequency expressed as a percentage, blood pressure, age, blood lipids, body mass index and other data are±SEM, said test parameters in each group compared with the mean t test, differences in the frequency of each group using X2 test, X2 test calculations confirm the Mantel-Haenszel odds ratio (odds ratio, OR) with 95% confidence interval, intervention on the relationship between each group compared with the application of univariate and multivariate analysis of variance or analysis of covariance, P<0.05 as statistically significant difference.Results1, All subjects of the RF exposure proportions were excessive body weight, blood lipids, IMT thickening, blood glucose, blood pressure, smoking. The detection rates were.38.73%.34.51%.31.99%.26.26%.24.91%and 23.65%.2,CHD group SBp, DBp, BG, TC, Lpa, BMI, WL, IMT was significantly higher than the distribution of RF group (P<0.05-0.001).3, RP group compared before and after intervention showed that the observed indicators in the first and second follow-up have improved, RF-I group improved significantly, but the difference was not statistically significant, the third follow-up, Group RF-I compared to the control group, had a statistically significant difference, IFG (P<0.01), TC (P O.01), TG (P<0.001), BMI (P<0.05) and WL (P<0.05) improved significantly.4, CHD at the end of the intervention two groups comparison showed a statistically significant difference, IFG (P＜0.05), TC (P<0.05), BMI (P<0.01) and WL (P<0.05) improved significantly, smoking and smoking cessation results improved significantly (P<0.05).5, RF-I and CHD-I the two intervention groups mainly to improve the indicators of the comparison showed that blood lipid and blood pressure before and after intervention significantly different (P<0.01～0.05), TG,Lpa,glucoserate and IMT of carotid artery intimal thickening were improved before and after intervention, but the difference was not significant (P> 0.02-0.05).Conclusions1, Shandong coastal areas patients suffering from coronary heart disease were exposed to analysis of cardiovascular risk factors, hypertension, abnormal blood sugar, hyperlipidemia, excessive body weight, smoking and IMT thickening 23.56% detection rate of～38.73%.2,The main risk factors are closely related to lifestyle, changing lifestyles, and whether high risk or coronary heart disease, can significantly slow down the major risk factors to control and increase speed and reduce the incidence of cardiovascular disease;3, The major risk factors are closely related to lifestyle, changing lifestyles, whether high risk population or coronary heart disease patients, can significantly slow down the rising speed of the major risk factor and reduce cardiovascular disease events.4, For coronary heart disease patients, active personalized intervention can significantly improve the level of knowledge and behavior related to compliance, reduce risk factors exposure and improve prognosis.5, Medical education from health care professionals and patient's own active participation can significantly increase the effectiveness of the intervention and control of the risk factors; these are of extremely important significance for community health. |
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