Randomized controlled trial on lifestyle modification in hypertensive patients

The authors examined the effects of a comprehensive lifestyle modification intervention on blood pressure (BP) and other cardiovascular risk factors in hypertensive patients. A total of 70 participants were randomly placed into either a lifestyle intervention or a control group. Four education classes and individual counseling sessions were held for the intervention group. Participants in the control group were provided with routine outpatient services and were asked to maintain their usual lifestyle. Data were gathered at baseline and at the end of 6 months. At the end of 6 months, BP, body weight, body mass index, waist circumference, and fasting lipids, apart from high-density lipoprotein cholesterol, significantly declined in the intervention group. Healthpromoting lifestyle scores of the intervention group had increased significantly compared to those of the control group. In conclusion, the results demonstrate the feasibility of comprehensive lifestyle modification and show its beneficial effects.     

Smoking or its cessation does not alter the susceptibility to in vitro LDL oxidation

BACKGROUND: Enhanced induction of low density lipoprotein (LDL) oxidation may play a role in the increased cardiovascular risk in smokers. We determined LDL oxidisability in vitro in non-smokers, smokers and in subjects after smoking cessation. PATIENTS AND METHODS: Plasma lipids and copper induced LDL oxidation in vitro were measured in 31 persistent smokers, 47 smokers who tried to stop smoking and 25 non-smokers. In the smoking cessation group, blood was collected before then 1, 3, 6 and 12 months after smoking cessation, and in the persistent smoking and non-smoking groups at baseline and after 12 months. Plasma thiobarbituric acid reactive substances (TBARS) were measured 3 times (at baseline then after 1 and 3 months) in all subjects who refrained from smoking (controlled by urinary cotinine concentrations) for at least 3 months. RESULTS: At baseline, no differences in mean age, body mass index and lipid profiles between groups were present. Seventeen subjects of the smoking cessation group (36%) managed to quit during 12 months. Smoking cessation was associated with an increase in mean weight (P 相似文献   

Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program

OBJECTIVE: The Diabetes Prevention Program demonstrated the ability to delay or prevent type 2 diabetes in participants with impaired glucose tolerance (IGT). Participants with IGT are at high risk for cardiovascular disease (CVD), with a marked increase in the number and severity of CVD risk factors. We prospectively assessed the impact of our interventions on hypertension, dyslipidemia, and CVD events. RESEARCH DESIGN AND METHODS: The study group consisted of 3,234 individuals with IGT randomly assigned to receive intensive lifestyle intervention, metformin, or placebo. Annual assessment of blood pressure, lipids, electrocardiogram, and CVD events was undertaken. RESULTS: Hypertension was present in 30% of participants at study entry and then increased in the placebo and metformin groups, although it significantly decreased with intensive lifestyle intervention. Triglyceride levels fell in all treatment groups, but fell significantly more with intensive lifestyle intervention. Total cholesterol and LDL cholesterol levels were similar among treatment groups. Intensive lifestyle intervention significantly increased the HDL cholesterol level and reduced the cumulative incidence of the proatherogenic LDL phenotype B. At 3 years of follow-up, the use for pharmacologic therapy to achieve established goals in the intensive lifestyle group was 27-28% less for hypertension and 25% less for hyperlipidemia compared with placebo and metformin groups. Over an average of 3 years, 89 CVD events from 64 participants were positively adjudicated studywide, with no differences among treatment groups. CONCLUSIONS: Lifestyle intervention improves CVD risk factor status compared with placebo and metformin therapy. Although no differences in CVD events were noted after 3 years, achieved risk factor modifications suggest that longer intervention may reduce CVD event rates.     

Incentivizing healthy lifestyle behaviors to reduce cardiovascular risk in people with serious mental illness: An equipoise randomized controlled trial of the wellness incentives program

BackgroundMedicaid recipients with serious mental illness die 25–30 years earlier than people in the general population due to health conditions that are modifiable through lifestyle changes. Cardiovascular diseases from excess weight, smoking, and sedentary lifestyle contribute substantially to this life expectancy disparity. The current study evaluated the impact of incentives on participation in weight management programming (for overweight and obese adults) and smoking cessation treatment (for regular smokers).MethodsParticipants were Medicaid recipients with disabling mental illness receiving services at any one of 10 community mental health centers across New Hampshire. Using an equipoise stratified randomized design, n = 1348 were enrolled and assigned to one of four weight management programs (Healthy Choices Healthy Changes: HCHC) and n = 661 were enrolled and assigned to one of three smoking cessation interventions (Breathe Well Live Well: BWLW). Following assignment to an intervention, participants were randomized to receive financial incentives (to attend weight management programs, or to achieve abstinence from smoking) or not. Data were collected at baseline and every 3 months for 12 months.DiscussionNew Hampshire's HCHC and BWLW programs were designed to address serious and preventable health disparities by providing incentivized health promotion programs to overweight/obese and/or tobacco-smoking Medicaid beneficiaries with mental illness. This study was an unprecedented opportunity to evaluate an innovative statewide implementation of incentivized health promotion targeting the most at-risk and costly beneficiaries. If proven effective, this program has the potential to serve as a national model for widespread implementation.     

Smokers in Västerbotten County, Sweden. What contributes to increased cardiovascular risk among heavy smokers?

OBJECTIVE: To analyse risk factor levels and risk factor patterns among heavy smokers compared to never smokers. DESIGN: An incident case-referent study. SETTING: The study was nested within the V?sterbotten Intervention Programme (VIP). SUBJECTS: 286 people (62 women and 224 men) claimed to be heavy smokers, i.e. smoked 25 cigarettes or more per day. For each of them, two referents (who reported never to have been smokers) were matched on age and gender (572 referents). MAIN OUTCOME MEASURES: Differences in biomedical variables and social and lifestyle factors were confirmed. RESULTS: S-cholesterol, s-triglycerides, fasting blood glucose, body weight and body mass index were all significantly elevated among the heavy smokers. Some gender differences were also found. Social and lifestyle factors differed significantly between heavy smokers and never smokers, but without gender differences. CONCLUSIONS: Heavy smokers carry a risk factor pattern corresponding to an increased risk of developing cardiovascular disease. Unfavourable changes in serum lipids and in glucose metabolism can exacerbate other deleterious effects of tobacco smoke on the cardiovascular system. Obviously, heavy smokers and never smokers differ not only in regard to biomedical variables but also to lifestyle and social health determinants. These are important factors to consider in public health efforts aimed at reducing the increased risk for cardiovascular diseases among smokers.     

Effectiveness of individual lifestyle interventions in reducing cardiovascular disease and risk factors

In order to assess the effectiveness of lifestyle interventions in reducing cardiovascular disease risk factors, morbidity and mortality among working-age adults, we undertook a systematic review of randomized controlled trials of various lifestyle interventions (diet, exercise, smoking cessation, alcohol intake reduction) in adults followed for 1 year or longer. Twenty-one single-factor and 21 multifactorial interventions were analysed by outcome. Changes in cardiovascular morbidity and mortality and total mortality were considered as main outcomes. Changes in weight, total cholesterol, blood pressure, sodium excretion, smoking and alcohol consumption were also analysed, and numbers needed to treat were calculated for smoking, morbidity and mortality. In secondary prevention, both single and multifactorial lifestyle interventions were shown to reduce morbidity and mortality, and multifactorial approaches reduced cholesterol levels. Primary prevention was found to reduce risk factors efficiently, especially when the intervention is multifactorial. Effect sizes were heterogeneous with wide confidence intervals. Standardized ways of describing interventions, measuring their effects and reporting outcomes systematically would facilitate effect-size evaluations. Interventions should optimally be multifactorial and targeted at high-risk patients with multiple risk factors for cardiovascular disease.     

Effectiveness of individual lifestyle interventions in reducing cardiovascular disease and risk factors

In order to assess the effectiveness of lifestyle interventions in reducing cardiovascular disease risk factors, morbidity and mortality among working-age adults, we undertook a systematic review of randomized controlled trials of various lifestyle interventions (diet, exercise, smoking cessation, alcohol intake reduction) in adults followed for 1 year or longer. Twenty-one single-factor and 21 multifactorial interventions were analysed by outcome. Changes in cardiovascular morbidity and mortality and total mortality were considered as main outcomes. Changes in weight, total cholesterol, blood pressure, sodium excretion, smoking and alcohol consumption were also analysed, and numbers needed to treat were calculated for smoking, morbidity and mortality. In secondary prevention, both single and multifactorial lifestyle interventions were shown to reduce morbidity and mortality, and multifactorial approaches reduced cholesterol levels. Primary prevention was found to reduce risk factors efficiently, especially when the intervention is multifactorial. Effect sizes were heterogeneous with wide confidence intervals. Standardized ways of describing interventions, measuring their effects and reporting outcomes systematically would facilitate effect-size evaluations. Interventions should optimally be multifactorial and targeted at high-risk patients with multiple risk factors for cardiovascular disease.     

Coronary heart disease risks and lifestyle behaviors in persons with HIV infection.

Metabolic complications such as HIV-associated lipodystrophy syndrome are common in patients with HIV-1 infection who are taking highly active antiretroviral therapy. HIV-associated lipodystrophy syndrome is characterized by dyslipidemia, fat redistribution, and altered glucose metabolism; however, there has been little study of relationships between these risk factors for coronary heart disease (CHD) and lifestyle risks. The aims of this study were to (a) describe the physical activity levels, nutrition habits, and smoking behaviors of persons with HIV-1 infection; (b) describe their CHD risks and estimate 10-year risk for CHD outcomes; and (c) examine the relationship between potentially modifiable lifestyle behaviors and risk factors for atherosclerotic cardiovascular disease in persons with HIV-1 infection receiving highly active antiretroviral therapy. Variables included lipid profile and other metabolic indices, body fat distribution, body mass index, blood pressure, and lifestyle behaviors (physical activity, dietary habits, smoking). A cross-sectional design and convenience sampling (n = 95) was used. Participants had multiple modifiable risk factors: 20% had a 10-year risk of 10% or higher of developing CHD. Results underscore the need for health promotion interventions to target lifestyle risks in persons with HIV-1 infection taking highly active retroviral therapy.     

Rationale and design of a clinical trial investigating resistance training as an aid to smoking cessation in persons with multiple sclerosis

Cigarette smoking is the leading preventable cause of death and disease among adults, and there is evidence that smokers with multiple sclerosis (MS) are at an increased risk for accelerated disease conversion and progression toward disability. Recent research has shown resistance training (i.e., weight training) to be beneficial for smoking cessation in the general population; however, no study has examined the use of resistance training as an aid to cessation in those with MS. Methods: After receiving brief smoking cessation counseling and the nicotine patch, smokers with relapsing-remitting MS will be randomized into a Resistance Training (RT) or Contact Control (CC) group. Participants in the RT group will attend a 60-minute resistance training session twice weekly for eight weeks, while participants in the CC will attend a 30-minute health education control session twice weekly for eight weeks. Measurements will be taken at baseline, weekly during the intervention, at the end of the eight-week study period, and at a one-month follow-up. The primary outcome will be smoking cessation, indicated by a 7-day abstinence, and verified by biochemical assay (i.e., carbon monoxide breath test). Secondary outcomes will include other smoking-related variables (e.g., nicotine withdrawal symptoms), multiple sclerosis-related factors (e.g., fatigue), and physical assessments (e.g., muscular strength). Discussion: The results from this study will lay the foundation for subsequent tests of the intervention in smokers with MS, with the long-term goal of providing specific recommendations and guidelines for smoking cessation that can be integrated into the clinical care of persons with MS.     

吸烟状态对男性心力衰竭患者远期心血管不良事件的影响研究

目的 探讨吸烟状态对男性心力衰竭患者远期心血管不良事件的影响。方法 连续入组2013年1月-2018年6月期间诊断的男性心力衰竭患者98例。记录患者的年龄、体重指数、病程、心功能分级、血压、心率、左心室射血分数（LVEF）、基础疾病史、用药情况等。根据吸烟状态，患者分为从不吸烟、已经戒烟、目前吸烟。随访1年，时间截至2019年6月30日，记录患者的临床结局，主要心血管不良事件包括需要住院治疗的心力衰竭，死亡和心源性死亡。使用多变量COX回归分析不同吸烟状态对远期心血管不良事件的影响。结果 本研究中从不吸烟40例（40.82%）、已经戒烟39例（39.80%）、目前吸烟19例（19.39%）。不同吸烟状态患者收缩压、舒张压、心率、高血压病、2型糖尿病、β受体阻滞剂比较差异均有统计学意义（P<0.05）。随访1年，不同吸烟状态患者需要住院治疗的心力衰竭、全因死亡和心源性死亡发生率比较，差异均有统计学意义（P<0.05）。多因素COX回归分析结果显示，排除其他因素干扰后，目前吸烟为需要住院治疗的心力衰竭、全因死亡和心源性死亡的危险因素（P<0.05）。结论 目前吸烟是男性心力衰竭患者长期需要住院治疗、全因死亡和心源性死亡的危险因素，临床医生应对心力衰竭患者进行健康教育，督促其戒烟，以促进其长期预后。     

The Impact of CAROtid plaque Screening on Smoking (CAROSS) cessation and control of other cardiovascular risk factors: Rationale and design of a randomized controlled trial

BackgroundScreening tests for subclinical cardiovascular disease, such as markers of atherosclerosis, are increasingly used in clinical prevention to identify individuals at high cardiovascular risk. Being aware of these test results might also enhance patient motivation to change unhealthy behaviors but the effectiveness of such a screening strategy has been poorly studied.MethodsThe CAROtid plaque Screening trial on Smoking cessation (CAROSS) is a randomized controlled trial in 530 regular smokers aged 40–70 years to test the hypothesis that carotid plaque screening will influence smokers' behavior with an increased rate of smoking cessation (primary outcome) and an improved control of other cardiovascular risk factors (secondary outcomes) after 1-year follow-up. All smokers will receive a brief advice for smoking cessation, and will subsequently be randomly assigned to either the intervention group (with plaque screening) or the control group (without plaque screening). Carotid ultrasound will be conducted with a standard protocol. Smokers with at least one carotid plaque will receive pictures of their own plaques with a structured explanation on the general significance of plaques. To ensure equal contact conditions, smokers not undergoing ultrasound and those without plaque will receive a relevant explanation on the risks associated with tobacco smoking. Study outcomes will be compared between smokers randomized to plaque screening and smokers not submitted to plaque screening.SummaryThis will be the first trial to assess the impact of carotid plaque screening on 1-year smoking cessation rates and levels of control of other cardiovascular risk factors.     

Birth weight for gestational age and later cardiovascular health: a comparison between longitudinal Finnish and indigenous Australian cohorts

IntroductionSmall or large birth weight for gestational age has been linked with later cardiovascular disease risk. However, cardiovascular risk markers from childhood to adulthood according to birth weight in diverse longitudinal settings globally have not been extensively studied.ObjectivesTo examine the relationship between birth weight and cardiovascular risk profile from childhood until young adulthood in two geographically and socioeconomically distinct cohorts.MethodsData were derived from two longitudinal birth cohort studies; one from southern Finland (Special Turku Coronary Risk Factor Intervention Project, STRIP) and one from northern Australia comprising Indigenous Australians (Aboriginal Birth Cohort, ABC). The sample included 747 Finnish participants and 541 Indigenous Australians with data on birth weight, gestational age and cardiovascular risk factors (body mass index [BMI]), waist-to-height ratio [WHtR], lipid profile, blood pressure) collected at ages 11, 18 and 25 or 26 years. Carotid intima-media thickness (cIMT) was assessed at age 18 or 19 years. Participants were categorised according to birth weight for gestational age (small [SGA], appropriate [AGA] or large [LGA]). Associations between birth weight category and cardiovascular risk markers were studied using a repeated measures ANOVA.ResultsHigher birth weight category was associated with higher BMI later in life in both cohorts (p=.003 for STRIP and p<.0001 for ABC). In the ABC, higher birth weight category was also associated with higher WHtR (p=.004). In the ABC, SGA participants had lower systolic and diastolic blood pressure than AGA participants (p=.028 for systolic, p=.027 for diastolic) and lower systolic blood pressure than LGA participants (p=.046) at age 25. In the STRIP cohort, SGA participants had lower cIMT than LGA participants (p=.024).ConclusionsBirth weight can predict future cardiovascular risk profile in diverse populations. Thus, it needs to be included in targeted public health interventions for tackling the obesity pandemic and improving cardiovascular health worldwide.

Key messages

• The strongest association between birth weight and later cardiovascular risk profile was manifested as differences in body mass index in two culturally and geographically distinct cohorts.
• Foetal growth is a determinant for later cardiovascular health in diverse populations, indicating a need to focus on maternal and foetal health to improve cardiovascular health worldwide.

     

Recognition, pathogenesis, and treatment of different stages of nephropathy in patients with type 2 diabetes mellitus

Nephropathy is a common microvascular complication among patients with type 2 diabetes mellitus and a major cause of kidney failure. It is characterized by albuminuria (≥ 300 mg/d) and a reduced glomerular filtration rate and is often present at the time of diabetes diagnosis after the kidney has been exposed to chronic hyperglycemia during the prediabetic phase. A low glomerular filtration rate (<60 mL/min/1.73 m(2)) is also an independent risk factor for cardiovascular events and death. Detection of diabetic nephropathy during its initial stages provides the opportunity for early therapeutic interventions to prevent or delay the onset of complications and improve outcomes. An intensive and multifactorial management approach is needed that targets all risk determinants simultaneously. The strategy should comprise lifestyle modifications (smoking cessation, weight loss, increased physical activity, and dietary changes) coupled with therapeutic achievement of blood glucose, blood pressure, and lipid goals that are evidence-based. Prescribing decisions should take into account demographic factors, level of kidney impairment, adverse effects, risk of hypoglycemia, tolerability, and effects on other risk factors and comorbidities. Regular and comprehensive follow-up assessments with appropriate adjustment of the therapeutic regimen to maintain risk factor control is a vital component of care, including referral to specialists, when required.     

Biologic and quality-of-life outcomes from the Mediterranean Lifestyle Program: a randomized clinical trial

OBJECTIVE: Few multiple lifestyle behavior change programs have been designed to reduce the risk of coronary heart disease in postmenopausal women with type 2 diabetes. This study tested the effectiveness of the Mediterranean Lifestyle Program (MLP), a comprehensive lifestyle self-management program (Mediterranean low-saturated fat diet, stress management training, exercise, group support, and smoking cessation), in reducing cardiovascular risk factors in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS: Postmenopausal women with type 2 diabetes (n = 279) were randomized to either usual care (control) or treatment (MLP) conditions. MLP participants took part in an initial 3-day retreat, followed by 6 months of weekly meetings, to learn and practice program components. Biological end points were changes in HbA(1c), lipid profiles, BMI, blood pressure, plasma fatty acids, and flexibility. Impact on quality of life was assessed. RESULTS: Multivariate ANCOVAs revealed significantly greater improvements in the MLP condition compared with the usual care group on HbA(1c), BMI, plasma fatty acids, and quality of life at the 6-month follow-up. Patterns favoring intervention were seen in lipids, blood pressure, and flexibility but did not reach statistical significance. CONCLUSIONS: These results demonstrate that postmenopausal women with type 2 diabetes can make comprehensive lifestyle changes that may lead to clinically significant improvements in glycemic control, some coronary heart disease risk factors, and quality of life.     

Primary prevention programs to reduce heart disease risk in women

Cardiovascular disease is the number one killer of women. Despite this statistic, many women do not perceive heart disease as a priority health concern. Recognizing that prevention begins in the community, the American Hospital Association launched a national fellowship program in 1998 to improve cardiovascular health. This article describes a practice innovation designed by a clinical nurse specialist who participated as a 1999-2000 cardiovascular fellow. The Women's Prevention Center, a community-based clinic within the walls of a heart hospital, provides a personalized cardiovascular assessment for women, including both heart history and assessment of physical parameters (eg, blood pressure, fasting glucose, lipid panel, waist-hip ratio). From this assessment, women are counseled on strategies to modify their individual risk factors, such as smoking cessation, heart-healthy nutrition and exercise, and are assisted in developing realistic lifestyle or medical management goals. After the initial assessment, outcomes are measured at 3-, 6-, and 12-month follow-ups to determine both individual success with behavior changes and program effectiveness.     

Randomized comparison of a nicotine inhaler and bupropion for smoking cessation and relapse prevention

OBJECTIVE: To compare the combination of a nicotine inhaler and bupropion to either treatment alone for initiating smoking abstinence and relapse prevention. METHODS: Smokers were randomized to receive a nicotine inhaler, bupropion, or both for 3 months. At 3 months, smoking-abstinent study participants were randomized to their initial medications or placebo. Participants who were smoking at 3 months were randomized to an alternative treatment regimen or placebo. This study was conducted from July 2001 to January 2003. RESULTS: A total of 1700 smokers were randomized to treatment (phase 1) for 3 months. Among the 941 study participants eligible for randomization to the phase 2 trial, 837 continued in the study. For the phase 2 trial, 405 smoking-abstinent participants were randomized to relapse prevention for 9 additional months, and 432 smokers were randomized to re-treatment for an additional 3 months. At the end of the initial 3 months of treatment (phase 1), 82 (14%) of 566, 145 (26%) of 567, and 194 (34%) of 567 study participants receiving a nicotine inhaler, bupropion, or both, respectively, were abstinent from smoking. Of the 405 smoking-abstinent participants at the end of 3 months, the bupropion group had more smokers than the placebo group (mean No. of smokers, 1.5 vs 1.1; P < .001), and the nicotine inhaler group had higher smoking abstinence rates at 12 months than the placebo group. Those receiving combination therapy had reduced rates of relapse to smoking for the first 3 months of relapse prevention, but this difference disappeared after the initial 3 months. Of the 432 study participants who were smoking at the end of 3 months and who received an alternative treatment regimen, the 223 smokers initially assigned to a nicotine inhaler were more likely to stop smoking at 6 months if they were re-treated with bupropion instead of placebo (8 [7%] of 111 vs 0 [0%] of 112; P = .003), and the 209 smokers initially treated with bupropion and re-treated with a nicotine inhaler did not have significantly higher smoking abstinence rates (6 [6%] of 104 vs 3 [3%] of 105; P = -.50). CONCLUSION: Combined therapy with a nicotine inhaler and bupropion increased smoking abstinence rates. Continuation of the initial combination therapy does not appear to prevent relapse to smoking. Timing of re-treatment and alternative approaches to relapse prevention should be further examined.     

Cardiovascular disease risk assessment and prevention in blood donors

BACKGROUND: Blood centers have implemented public health initiatives, including cardiovascular disease (CVD) screening, to improve donor and community health and serve as an incentive to donate. STUDY DESIGN AND METHODS: CVD risk screening and counseling were performed at mobile blood drives in diverse neighborhoods. Risk factors were determined by point‐of‐care testing (total cholesterol, high‐density lipoprotein, and hemoglobin A1c levels), interviews, and physical examinations (body mass index, waist circumference, and blood pressure). Results were confidentially relayed to participant by health counselors. A 60‐day follow‐up survey was sent to some participants. RESULTS: Over 11 months, 2406 participants (44% male; mean age 28 ± 16; 67% minority racial/ethnic group) were screened at 290 mobile drives. A total of 92% of participants had medical insurance. A total of 14% had none, 26% one, 33% two, and 27% three or more risk factors. A total of 72% of teenage participants had at least one risk factor. A total of 18% of participants who were taking medications for risks were poorly controlled. A total of 15% had newly identified risks. A total of 711 participants completed follow‐up survey: 21% sought medical care, 51% were motivated to change their lifestyle, 81% were pleased with screening, 48% were more likely to donate, and 62% recommended donation to friends and family because of the screening. CONCLUSION: CVD risk screening and counseling can occur during a mobile blood drive. A majority of participants screened had risk factors. Follow‐up surveys showed that the program was well received. Further studies are planned to evaluate long‐term effects of the program on donor health and donor return rates.     

高血压前期健康管理效果的临床研究

目的观察高血压前期规范化健康管理成效。方法 2008年1月至2011年6月固定单位职工连续行常规健康体检中的高血压前期2级人群,2008年为对照组,2009年始进行为期3年的健康管理。管理结束,以治疗性生活方式改变情况、体质量、血糖、血脂、血压水平等指标,评估管理效果。结果 (1)治疗性生活方式改善明显,摄盐过多、高脂饮食、吸烟、经常饮酒、很少运动有不同比例减低,同2008年干预前比较,差异明显(P<0.01)。(2)干预后体质量、血糖、血脂、血肌酐水平有不同程度改善,差异具有统计学意义(P<0.01)。(3)血压水平明显下降,2011年收缩压水平较2008年下降(7.8±0.82)mm Hg,舒张压下降(6.7±0.43)mm Hg。2009-2011年与2008年血压水平比较,差异显著(P<0.01)。结论高血压前期规范化健康管理干预效果显著,通过管理能改善心血管危险因素,有效控制血压水平,延缓或降低高血压前期进展为高血压病的风险。