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Áhættuþættir slagæðasjúkdóma og gildi breytts lífsstíls : könnun á meðal íbúa á aldrinum 35-65 ára í Öxarfjarðarhéraði

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Authors
Guðrún G. Eggertsdóttir
Sigurður Halldórsson
Issue Date
1998-04-01

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Cardiovascular risk factors and the value of changes in lifestyle. Results from a study of people aged 35-65 in a small rural community in Iceland
Citation
Læknablaðið 1998, 84(4):282-89
Abstract
Object: To find the prevalence of cardiovascular risk factors in Öxarfjarðarhérað, a small rural community in north-eastern Iceland, and to see if these risk factors could be influenced with simple measurements and interventions in the community. Material and methods: The study group included every person between the age of 35-65, living in the community. The participants were interviewed by a nurse. Cardiovascular risk factors were registered and measured. The results were discussed with each person individually and verbal and written advise given by the nurse, with emphasis on each individual's own responsibility regarding lifestyle changes. A total of 126 persons came to the initial interview, or 97%. A follow-up interview was carried out after six to seven months for those two thirds of the sample who had one or more risk factors. Sixty-eight attended, or 80%. Results: Two thirds of the study population had some risk factors for cardiovascular disease, thereof 35 individuals with s-cholesterol >6.0 mmol/1. Average weight for men was 84.7 kg and women 77.1 kg. Average cholesterol was 6.0 mmol/1 for men and 5.9 for women. Four new hypertensives were found and treated. From the second interview we found that 40-46% of those who had been told that they had high s-cholesterol had increased their physical activity and reduced food fat and sugar. This same group also proved to have decreased their average weight (-1.6 kg) and s-cholesterol (-1.1 mmol/1) significantly. No significant changes were found regarding smoking or blood pressure. Conclusion: A short interview and simple measurements at a local health centre are effective, at least in the short term in altering life style factors such as physical activity and intake of fat and sugar in certain risk groups, thereby inducing a significant decrease in s- cholesterol and thus hopefully reduce the incidence of premature cardiovascular events. In view of the above, we encourage all health care workers to introduce these simple lifestyle changes to their clients.
Slagæðasjúkdómar eru algengir á íslandi og draga árlega fjölda manns til dauða, þar af marga ótímabært. Þeir eru um 50% dánarorsaka karla á aldrinum 34-74 ára og um 26% kvenna á sama aldri (1). Hátt kólesteról í blóði, háþrýstingur, reykingar og sykursýki eru á meðal stærstu áhættuþátta. Sýnt hefur verið fram á að meðhöndlun þeirra er árangursrík leið til að minnka líkur á slagæðasjúkdómum (2-4). Niðurstöður hafa sýnt að 25% kólesteróllækkun leiddi til 30% lækkunar á tíðni kransæðadauðsfalla, og gagnast jafnt þeim sem hafa lág og há gildi (5); það er að „fylgnisamband er samfellt þannig að engin skil eru á milli æskilegs kólesteróls og þeirra gilda er auka áhættu" (6,7). Niðurstöður margra rannsókna hafa staðfest að lækka má kólesteról í blóði með aukinni hreyfingu og lækkun á hlutfalli mettaðrar fitu í fæðu (7-9). Samkvæmt tilmælum Manneldisráðs á hlutur fitu í fæði að vera undir 35% (rit Manneldisráðs, 1996) (10,11). Kostnaður við eftirlit og sérhæfðar rannsóknir vegna áhættuþátta æðasjúkdóma er oft mikill, ferðalög íbúa í dreifbýli dýr svo ekki sé minnst á þau fjárútlát sem fylgja hverjum þeim einstaklingi sem fær slagæðasjúkdóm. Með markvissu eftirliti, einföldum rannsóknum og fræðslu frá fagfólki sem miðar að breyttum lífsstíl og því að gera einstaklinginn sjálfan ábyrgan fyrir heilsu sinni gæti verið hægt að minnka þann kostnað (12). Tilgangur þessarar rannsóknar var að kanna algengi áhættuþátta slagæðasjúkdóma og reyna að minnka áhættuna með einföldum mælingum og faglegri ráðgjöf heima í héraði.
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