Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members.

Autor: Brar R; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada., Whitlock RH; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada., Katz A; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Department of Family Medicine, Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada., Di Nella M; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada., Komenda P; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada., Bohm C; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada., Rigatto C; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada., Tangri N; Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada., Solmundson C; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Wellness Institute Winnipeg Manitoba Canada., Collister D; Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada.; Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.; Department of Medicine, Faculty of Medicine & Dentistry University of Alberta Edmonton Alberta Canada.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Apr 02; Vol. 13 (7), pp. e030028. Date of Electronic Publication: 2024 Mar 27.
DOI: 10.1161/JAHA.123.030028
Abstrakt: Background: Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming.
Methods and Results: We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low-frequency attenders (≤1 weekly visit) and regular-frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event-plus (hazard ratio [HR], 0.88 [95% CI, 0.81-0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event-plus compared with controls, but the effect was not significant for lower weekly attendance (low-frequency attenders: HR, 0.94 [95% CI, 0.85-1.04]; regular-frequency attenders: HR, 0.77 [95% CI, 0.67-0.89]).
Conclusions: Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event-plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.
Databáze: MEDLINE
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