• Ignacio Párraga-Martínez, Francisco Escobar-Rabadán, Joseba Rabanales-Sotos, Fernando Lago-Deibe, Juan M Téllez-Lapeira, Alejandro Villena-Ferrer, Mariano Blasco-Valle, José M Ferreras-Amez, Susana Morena-Rayo, José M Del Campo-Del Campo, M Candelaria Ayuso-Raya, and José J Pérez-Pascual.
• Centro de Salud de La Roda, Gerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain. Electronic address: iparraga@sescam.jccm.es.
• Rev Esp Cardiol (Engl Ed). 2018 Jan 1; 71 (1): 33-41.

Introduction And ObjectivesSeveral interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise).MethodsA multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months.ResultsAt 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6mg/dL [95%CI, 8.9-20.4]; P=.034). The mean LDL-C decrease was 13.1%±28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P=.011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P=.029) and exercise (64.9% vs 35.8; P<.001), but not to diet.ConclusionsThe combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year.Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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