{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T21:27:44Z","timestamp":1785274064791,"version":"3.55.0"},"reference-count":30,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2016,12,15]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>National guidance for England recommends that cardiovascular disease (CVD) should be managed as a family of diseases in the community. Here, we describe the results of such an approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with established CVD or who were at high multifactorial risk (HRI) underwent a 12-week community-based nurse-led prevention programme (MyAction) that included lifestyle and risk factor management, prescription of medication and weekly exercise and education sessions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over a 6-year period, 3232 patients attended an initial assessment; 63% were male, and 48% belonged to black and minority ethnic groups. 56% attended an end-of-programme assessment, and 33% attended a one year assessment. By the end of the programme, there was a significant reduction in smoking prevalence but only in HRI (\u22123.7%, p&lt;0.001). Mediterranean diet score increased in both CVD (+1.2, p&lt;0.001) and HRI (+1.5; p&lt;0.001), as did fitness levels (CVD +0.8 estimated Mets maximum, p&lt;0.001, HRI +0.9 estimated Mets maximum, p&lt;0.001) and the proportions achieving their physical activity targets (CVD +40%, p&lt;0.001, HRI +37%, p&lt;0.001). There were significant increases in proportions achieving their blood pressure (CVD +15.4%, p&lt;0.001, HRI +25%, p&lt;0.001 and low-density lipoprotein cholesterol targets (CVD +6%, p=0.004, HRI +23%, p&lt;0.001). Statins and antihypertensive medications significantly increased in HRI. Significant improvements in depression scores and quality-of-life measures were also seen. The majority of improvements were maintained at 1 year.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These results demonstrate that an integrated vascular prevention programme is feasible in practice and reduces cardiovascular risk in patients with established CVD and in those at high multifactorial risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-310477","type":"journal-article","created":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T21:00:45Z","timestamp":1488488445000},"page":"840-847","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Outcomes of an integrated community-based nurse-led cardiovascular disease prevention programme"],"prefix":"10.1136","volume":"103","author":[{"given":"S B","family":"Connolly","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Kotseva","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Jennings","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Atrey","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"College of Health and Life Sciences, Brunel University, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Brown","sequence":"additional","affiliation":[{"name":"Public Health England, Fleetbank House, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Bassett","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,2]]},"reference":[{"key":"2025092002564909000_103.11.840.1","unstructured":". 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