Willeke A C Duffhues, Dennis G Barten, Harald De Cauwer, Luc Mortelmans, Frits van Osch, Derrick Tin, Marion P G Koopmans, Gregory Ciottone
Worldwide Trends in COVID-19-Related Attacks Against Healthcare: A Review of the Safeguarding Health in Conflict Coalition Database
Health security
objective review synthesize evidence effectiveness lifestylebased interventions mitigating absolute cardiovascular disease cvd risk evidencebased guidelines recommend employing absolute cvd risk score inform selection intensity preventive interventions however studies employing strategy reported mixed results hence need systematic review current evidence studies published english included lifestylebased intervention mitigate cvd risk considered studies eligible enrolled individuals aged 18 years history cvd baseline primary outcome change absolute cvd risk score postintervention pubmed embase cinahl searches conducted database inception february 2022 trial registers searched included cochrane central register controlled trials central clinicaltrialsgov searches unpublished studiesgray literature conducted proquest dissertations theses global greylit report oclc first search proceedings two independent reviewers selected studies critically appraised methodological quality using jbi tools data extraction performed main outcome variables data presented using separate pooled statistical metaanalysis quasiexperimental randomized clinical trials random effects models employed analyses effect sizes cohens expressed standardized mean difference 95 ci heterogeneity assessed via cochrans q statistic inconsistency index i2 used describe variability effect estimates due heterogeneity rather sampling error twentynine studies total sample 5490 adults cvd baseline included fifteen randomized controlled trials rcts n3605 14 quasiexperimental studies n1885 studies conducted europe n18 united states n 5 asia n3 mexico n1 canada n 1 australia n1 included following lifestyle interventions diet physical activity motivational interviewing problemsolving psychological counseling cardiovascular risk assessment feedback health selfmanagement education peer support six validated absolute cvd risk assessment tools used measure study outcomes including framingham score heart health risk assessment score dundee assign uk prospective diabetes study risk score overall methodological rigor rcts quasiexperimental studies high 15 rcts included metaanalysis lifestyle intervention favored control reducing absolute cvd risk score cohens 039 p 0032 z 214 i2 96 similarly 14 quasiexperimental studies absolute cvd risk score lifestyle intervention significantly lower compared baseline cohens 039 p 0001 z 354 i2 88 rcts combined diet physical activity reported significant impact absolute cvd risk score used either intervention independently reported significant improvement absolute cvd risk score evidence supporting positive impact lifestyle modification absolute cvd risk score adult populations without cvd analysis suggests diet physical activity significant impact absolute cvd risk variety validated screening tools used monitor evaluate communicate changes absolute risk score lifestyle modification spanishlanguage version abstract review available httplinkslwwcomsrxa29