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Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries
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Uthman, Olalekan A., Hartley, Louise, Rees, Karen, Taylor, Fiona, Ebrahim, Shah and Clarke, Aileen (2015) Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries. Cochrane Database of Systematic Reviews, 8 . CD011163. doi:10.1002/14651858.CD011163.pub2 ISSN 1469-493X.
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Official URL: http://doi.org/10.1002/14651858.CD011163.pub2
Abstract
Abstract
Background: Given the increasing incidence of cardiovascular diseases (CVDs) and lower CVD health awareness in low- and middle-income countries (LMICs) it is possible that multiple risk factor intervention programmes may have beneficial effects.
Objectives: To determine the effectiveness of multiple risk factor interventions aimed at modifying major cardiovascular risk factors for the primary prevention of CVD in LMICs.
Methods: We searched major electronic databases for randomised controlled trials of health promotion interventions to achieve behaviour change (i.e. smoking cessation, dietary advice, increasing activity
levels). We combined dichotomous data using risk ratios (RRs) and continuous data using mean differences (MDs), and presented all results with a 95% confidence interval (CI).
Results: Thirteen trials met the inclusion criteria. Two trials recruited healthy participants and the other 11 trials recruited people with varying risks of CVD, such as participants with known hypertension and
type 2 diabetes. The pooled effect indicated a reduction in systolic blood pressure (MD -6.72 mmHg, 95% CI -9.82 to -3.61, I² = 91%, 4868 participants), diastolic blood pressure (MD -4.40 mmHg, 95% CI -
6.47 to -2.34, I² = 92%, 4701 participants), body mass index (MD -0.76 kg/m², 95% CI -1.29 to -0.22, I² = 80%, 2984 participants) and waist circumference (MD -3.31, 95% CI -4.77 to -1.86, I² = 55%, 393 participants) in favour of multiple risk factor interventions.
Conclusions: There is some evidence that multiple risk factor interventions may lower blood pressure levels, body mass index and waist circumference in populations in LMIC settings at high risk of
hypertension and diabetes. There was considerable heterogeneity between the trials, the trials were small, and at some risk of bias. Larger studies with longer follow-up periods are required to confirm
whether multiple risk factor interventions lead to reduced CVD events and mortality in LMIC settings
| Item Type: | Journal Article | ||||||||||||||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Cardiovascular system--Diseases, Cardiovascular system--Diseases--Developing countries, Cardiovascular system--Diseases--Developing countries--Prevention, Diabetes, Diabetes--Developing countries--Prevention, Health promotion | ||||||||||||||||||
| Journal or Publication Title: | Cochrane Database of Systematic Reviews | ||||||||||||||||||
| Publisher: | John Wiley & Sons Ltd. | ||||||||||||||||||
| ISSN: | 1469-493X | ||||||||||||||||||
| Official Date: | 4 August 2015 | ||||||||||||||||||
| Dates: |
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| Volume: | 8 | ||||||||||||||||||
| Number of Pages: | 26 | ||||||||||||||||||
| Article Number: | CD011163 | ||||||||||||||||||
| DOI: | 10.1002/14651858.CD011163.pub2 | ||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||
| Date of first compliant deposit: | 5 August 2016 | ||||||||||||||||||
| RIOXX Funder/Project Grant: |
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