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Change in Coronary Risk Factor Levels in Couples After Lifestyle Intervention
The British Family Heart Study by Pyke et al1 used a family-centered approach to coronary risk reduction in married couples. The authors were able to demonstrate concordance between couples for coronary risk factors and concordance for change in coronary risk factors in these couples, but were unable to demonstrate to what extent these changes were related to family-centered lifestyle intervention. Although I found this study encouraging and thought provoking, I think that the study would have been strengthened if there had been more emphasis placed on couple participation in the follow-up sessions and if the intervention were longer than 1 year; perhaps then the correlation between family-centered intervention and extent of change in cardiovascular risk factors could have been more accurately determined.
This study certainly challenges us as primary care physicians to consider the effect that family dynamics has on the health behavior of our patients. I did a MEDLINE search and did not find any studies that specifically looked at the benefits of a family-centered approach to cardiovascular risk counseling. Family-centered coronary risk counseling provides another option for primary care physicians in their management of patients at risk for coronary heart disease. By targeting the family rather than the individual in lifestyle intervention and risk counseling, we could be more effective in our efforts to prevent coronary heart disease and, in doing so, contribute to improved health habits of future generations.
Valerie Anderson-Grant, MD
Atlanta, Ga
1. Pyke SDM, Wood DA, Kinmonth A-L, Thompson SG. Change in coronary risk and coronary risk factor levels in couples following lifestyle intervention: the British Family Heart Study. Arch Fam Med. 1997;6:354-360.
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Arch Fam Med. 1998;7:405.
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