| Summary: |
Cardiovascular disease (CVD) is the major cause of premature death in Portugal. It is an important cause of disability and contributes substantially to the escalating costs of healthcare. Death from CVD frequently occurs suddenly and before medical care is available, so the therapeutic interventions are either inapplicable or palliative . The mass occurrence of CVD relates
strongly to lifestyles behaviors and to biological modifiable risk factors. Risk factors tend to cluster, being the metabolic syndrome a good example of aggregation of multiple risk factors. In fact, risk factor modifications have been shown to reduce CVD mortality and morbidity, particularly in high-risk patients, thus reinforcing the importance of primary prevention.
In Portugal the available data regarding the prevalence of metabolic syndrome arises from few studies with a high range of values (from 32.9% up to 70.3%), enrolling in general small number of subjects and providing contrasting results comparing to the European studies (overall prevalence is 15%). Based on the incongruent data reporting the prevalence of metabolic syndrome in Portugal and on the importance of physical
activity in the prevention of the number one cause of death in the developed countries, the main purposes of this project are: 1) to determine the prevalence of CVD risk factors and metabolic risk factors and to characterize the global cardiovascular risk using the Heart Score; 2) to determine the association of CVD and metabolic risk factors, and overall cardiovascular risk assessed by
Heart Score with biomarkers of inflammation, daily physical activity, and cardiorespiratory fitness; 3) to determine the weight and contribution of physical (in)activity and cardiorespiratory fitness to the value of the global metabolic and cardiovascular risk and to the levels of the inflammatory biomarkers; 4) to evaluate the effects (at short and long-term - eight months follow up) of a educational and counseling interv  |
Summary
Cardiovascular disease (CVD) is the major cause of premature death in Portugal. It is an important cause of disability and contributes substantially to the escalating costs of healthcare. Death from CVD frequently occurs suddenly and before medical care is available, so the therapeutic interventions are either inapplicable or palliative . The mass occurrence of CVD relates
strongly to lifestyles behaviors and to biological modifiable risk factors. Risk factors tend to cluster, being the metabolic syndrome a good example of aggregation of multiple risk factors. In fact, risk factor modifications have been shown to reduce CVD mortality and morbidity, particularly in high-risk patients, thus reinforcing the importance of primary prevention.
In Portugal the available data regarding the prevalence of metabolic syndrome arises from few studies with a high range of values (from 32.9% up to 70.3%), enrolling in general small number of subjects and providing contrasting results comparing to the European studies (overall prevalence is 15%). Based on the incongruent data reporting the prevalence of metabolic syndrome in Portugal and on the importance of physical
activity in the prevention of the number one cause of death in the developed countries, the main purposes of this project are: 1) to determine the prevalence of CVD risk factors and metabolic risk factors and to characterize the global cardiovascular risk using the Heart Score; 2) to determine the association of CVD and metabolic risk factors, and overall cardiovascular risk assessed by
Heart Score with biomarkers of inflammation, daily physical activity, and cardiorespiratory fitness; 3) to determine the weight and contribution of physical (in)activity and cardiorespiratory fitness to the value of the global metabolic and cardiovascular risk and to the levels of the inflammatory biomarkers; 4) to evaluate the effects (at short and long-term - eight months follow up) of a educational and counseling intervention on physical activity, cardiorespiratory fitness, metabolic and CVD risk factors, biomarkers of inflammation, and global cardiovascular and metabolic risk.
To accomplish these purposes we intent to conduct a cross-sectional study (purposes #1 to #3) followed by a single-centre, prospective, randomized controlled study (purpose #4). For the cross-sectional study, 532 subjects will be randomly recruited from the universe of 8,000 subjects registered in the Family Health Unit of Aldoar (Porto). The subjects will be invited to participate and to undergo the following assessments: anthropometrics (height, weight, percentage of fat and fat free mass, and waist circumference), resting heart rate and blood pressure, daily physical activity, dietary intake, cardiorespiratory fitness, heart score, lipid profile and metabolic parameters, circulating levels of C-reactive protein, interleukin-6, tumor necrosis factor alpha, phospholipase A2, adiponectin, and leptin. From those 532, 150 will be randomly enrolled (restrict randomization) in the randomized controlled study (50 subjects in each group: SM, high CVD risk and control). The subjects in the intervention groups will participate in a educational and counseling program for 4 months consisting of 3 sessions of interaction with a health professional and receiving educational material (manual) focusing the risk factors and its management, and the importance of physical activity and how to achieve an active lifestyle. The control group will receive usual care. After the intervention period (4 months) and at 4 months follow-up the groups will |