Skip to main content
NCBI home page
Atencion Primaria logoLink to Atencion Primaria
. 2008 Dec 10;35(5):260–264. [Article in Spanish] doi: 10.1157/13072792

Ensayo clínico aleatorizado de una intervención intensiva sobre los estilos de vida de pacientes con hiperfibrinogenemia en prevención primaria de las enfermedades cardiovasculares en el ámbito de la atención primaria de salud

Randomised clinical trial of an intensive intervention into life-styles of patients with hyperfibrinogenaemia in primary prevention of cardiovascular pathology in primary health care

JJ Rodríguez Cristóbal a,⁎, F Benavides Márquez b, C Villaverde Grote c, E Peña Sendra c, F Flor Serra d, P Travé Mercadé e; en representación del grupo EFAP1
PMCID: PMC7684374  PMID: 15802115

Abstract

Objectives

To study the effect of an intensive programme to modify life-style on levels of plasma fibrinogen in patients without cardiovascular pathology, with high fibrinogen and normal cholesterol levels. To analyse whether the effect on fibrinogen is independent, or otherwise, of the effect on lipids.

Design

Randomised clinical trial with a control.

Setting

11 health districts in L’Hospitalet de Llobregat and Barcelona.

Participants

436 patients will be included, 218 individuals between 35 and 75 years old in each group, and without cardiovascular pathology (ischaemic cardiopathy, cerebral vascular accident or peripheral arteriopathy), with hyperfibrinogenaemia (fibrinogen ›300 mg/dL) and with plasma control ‹250 mg/dL.

Interventions

One group of patients will receive an intensive intervention (in frequency and intensity of counselling and treatment) for life-style changes, i.e. stopping smoking, low-calorie diet in case of overweight or obesity, and physical exercise. The follow-up of the intervention group will be every 2 months. The control group will follow customary treatments.

Measurements

Levels of plasma fibrinogen. In addition, other relevant events will be recorded over a 2-year monitoring period: modification of risk factors, changes in quality of life, cardiovascular events or death.

Discussion

The introduction of an intensive primary prevention intervention (life-style changes) in patients with hyperfibrinogenaemia could be a more effective measure than the habitual intervention for reducing plasma fibrinogen figures. In addition, these measures could be translated into a reduction of cardiovascular risk and an improvement in the patient́s quality of life.

Key words: Fibrinogen, Cardiovascular risk, Lifestyle changes

Bibliografía

  • 1.Villar Álvarez F., Maiques Galán A., Brotons Cuixart C., Torcal Laguna J., Lorenzo Piqueres A., Vilaseca Canals J. Prevención de las enfermedades cardiovasculares en atención primaria. Aten Primaria. 2001;28(Supl 2):13–26. [Google Scholar]
  • 2.Villaverde C.A. Fibrinógeno como factor de riesgo cardiovascular. Incidencia de los fibratos. Cardiovascular Risk Factors. 1994;3(Suppl 2):30–45. [Google Scholar]
  • 3.Downs J.R., Clearfield M., Weis S. Prevención primaria de los eventos coronarios agudos con lovastatina en varones y mujeres con concentraciones promedio de colesterol. Resultados del AFCAPS/TexCAPS. JAMA (ed. esp.) 1998;7:8. [Google Scholar]
  • 4.Fowkes F.G. Fibrinogen and cardiovascular disease in clinical practice. Eur Heart J. 1995;16(Suppl A):60–63. doi: 10.1093/eurheartj/16.suppl_a.60. [DOI] [PubMed] [Google Scholar]
  • 5.Ernst E., Resch K.L. Fibrinogen as cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med. 1993;118:956–963. doi: 10.7326/0003-4819-118-12-199306150-00008. [DOI] [PubMed] [Google Scholar]
  • 6.Dotevall A., Johansson S., Wilhelmsen L. Associaton between fibrinogen and other risk factor for cardiovascular disease in men and women. Results from the Goteborg MONICA survey 1985. Ann-Epidemiol. 1994;4:369–374. doi: 10.1016/1047-2797(94)90071-x. [DOI] [PubMed] [Google Scholar]
  • 7.Ernst E., Resch K.L. Therapeutic interventions to lower plasma fibrinogen concentration. Eur Heart J. 1995;16(Suppl A):47–53. doi: 10.1093/eurheartj/16.suppl_a.47. [DOI] [PubMed] [Google Scholar]
  • 8.Danesh J., Collins R., Appleby P., Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease:meta-analyses of prospective studies. JAMA. 1998;279:1477–1482. doi: 10.1001/jama.279.18.1477. [DOI] [PubMed] [Google Scholar]
  • 9.Masiá R., Pena A., Marrugat J., Sala J., Vila J., Pavesi M., The REGICOR Investigators High prevalence of cardiovascular risk factors in Gerona, Spain. A province with low myocardial infarction incidence. J Epidemiol Community Health. 1998;52:707–715. doi: 10.1136/jech.52.11.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Gil B., Avilés J., Maldonado A., Fernández M. Factores de riesgo en ancianos. Estudio de 143 pacientes. An Med Interna (Madrid) 1997;14:495–499. [PubMed] [Google Scholar]
  • 11.Rodríguez J.J., Villaverde C.A., Torelló L., Trocho C., Tibau N., Villaverde A.A. 15th Wonca World Conference; Dublin: 1998. Relationship between colesterol and fibrinogen in primary-care areas. p. 178. [Google Scholar]
  • 12.Rodríguez J.J., Villaverde C.A., Trocho C., Ortiz Y., Tibau N., Villaverde A. Significado de la hiperfibrinogenemia e hipercolesterolemia como marcadores de riesgo cardiovascular en relación con la localización geográfica de la población. XVIII Congreso Nacional de Medicina de Familia y comunitaria. Aten Primaria. 1998;22:348. [Google Scholar]
  • 13.Yano K., Grove J., Chen R., Rodríguez B.L., Curb J.D., Tracy R.P. Plasma fibrinogen as a predictor of total and cause-specific mortality in elderly Japanese-american men. Arterioscl Thromb Vasc Biol. 2001;21:1065–1070. doi: 10.1161/01.atv.21.6.1065. [DOI] [PubMed] [Google Scholar]
  • 14.Wood D., De Backer G., Faergeman O., Graham I., Mancia G., Pyörälä Prevention of coronary heart disease in clinical practice. Summary of recommendations the Second Joint Task Force of European and other Societies on Coronary Prevention. Eur Heart J Atherosclerosis. 1998;140:199–270. doi: 10.1016/s0021-9150(98)90209-x. [DOI] [PubMed] [Google Scholar]
  • 15.Kannel W.B. Influence of fibrinogen on cardiovascular disease. Drugs. 1997;54(Suppl 3):32–40. doi: 10.2165/00003495-199700543-00006. [DOI] [PubMed] [Google Scholar]
  • 16.Rodríguez JJ,Villaverde CA,Tibau N,Flor F, Mateos F,Peña E. Relationship of cardiovascular risk to plasma concentrations of fibrinogen. Finlandia, Tampere 2001, Conference of European Society of General Practice/Family Medicine.Wonca Region Europe. p. 139.
  • 17.Vilaseca J., Casajuana J., Ciurana R., Maiques A., Mundet X. Ediciones Doyma, S.L.; Barcelona: 2000. Hipercolesterolemia: protocolo de actuación. Sociedad Española de Medicina Familiar y Comunitaria. p. 5. [Google Scholar]
  • 18.Woolf S., Jonas S., Lawrence R. Williams and Wilkins; Nueva York: 1996. Health promotion and disease prevention in clinical practice. p. 177-223. [Google Scholar]
  • 19.Córdoba García R., Ortega Sánchez-Pinilla R., Cabezas Peña C., Forés García D., Nebot Adell M., Robledo de Dios T. Recomendaciones sobre estilo de vida. Aten Primaria. 2001;28(Supl 2):27–41. [PubMed] [Google Scholar]
  • 20.Hooper L., Summerbell C., Higgins J., Thompson R., Capps N., Smith G.D. Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ. 2001;322:757–763. doi: 10.1136/bmj.322.7289.757. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Atencion Primaria are provided here courtesy of Elsevier

RESOURCES