The Impact of Cardiovascular Risk Factor Case Management on the Metabolic Syndrome in a Primary Prevention Population: Results From a Randomized Controlled Trial

Authors

  • Patrick G. O'Malley MD, MPH,

    1. From the Department of Medicine, Division of General Internal Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC, and the Uniformed Services University of the Health Sciences, Bethesda, MD
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  • Courtney Kowalczyk BA,

    1. From the Department of Medicine, Division of General Internal Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC, and the Uniformed Services University of the Health Sciences, Bethesda, MD
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  • Jody Bindeman MSN,

    1. From the Department of Medicine, Division of General Internal Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC, and the Uniformed Services University of the Health Sciences, Bethesda, MD
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  • Allen J. Taylor MD

    1. From the Department of Medicine, Division of General Internal Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC, and the Uniformed Services University of the Health Sciences, Bethesda, MD
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Patrick G. O'Malley, MD, MPH, Division of General Internal Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307
E-mail: patrick.omalley@na.amedd.army.mil

Abstract

No study has examined the effect of case management on the development of the metabolic syndrome. The authors randomized 450 consenting, asymptomatic men and women to a 6-month cardiovascular case management program or usual care. Participants were reassessed at 1 year for change in a composite measure of five factors that define the metabolic syndrome. Of the cohort (mean age 42 years; 79% male), 46% had at least one metabolic syndrome factor and 4.3% had the metabolic syndrome. At 1 year, there was greater improvement in motivation to change in the case management group (+0.58 vs. +0.06, 10-point scale; p=0.001), lower incidence of the metabolic syndrome (1.5% vs. 4.5%; p=0.12), and lower prevalence (decrease of 0.8% vs. increase of 2.6%; p=0.04). A 6-month case management program focused on cardiovascular risk factors had a modest effect on the prevalence of the metabolic syndrome in this primary prevention screening population after 1 year. Further study is needed to clarify the overall health impact of preventing the metabolic syndrome.

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