The Effect of Community Care on Cardiovascular Disease Risk Factors: A Systematic Review and Meta‐Analysis

医学 血脂异常 戒烟 科克伦图书馆 心理干预 内科学 疾病 人口 荟萃分析 环境卫生 护理部 病理
作者
Jing Zhang,Ting Luo,Jiao Wang,Mingmin Zhang,Hong Wang,Wei Wu
出处
期刊:Journal of Evaluation in Clinical Practice [Wiley]
卷期号:31 (4)
标识
DOI:10.1111/jep.70106
摘要

ABSTRACT Rationale Cardiovascular disease (CVD) remains a leading global cause of morbidity and mortality, with hypertension, dyslipidemia, and smoking as key modifiable risk factors. While pharmacological interventions are effective, their accessibility in resource‐limited settings highlights the need for scalable nonpharmacological strategies. Community care has emerged as a potential solution, yet evidence on its efficacy in reducing CVD risk factors remains fragmented and inconsistent due to heterogeneity in intervention designs and population characteristics. Aim To evaluate the effectiveness of community care in reducing CVD risk factors (blood pressure, lipids, smoking) and explore geographical heterogeneity. Methods Fifteen RCTs ( n = 10,749) from PubMed, Embase, Cochrane Library, and Web of Science (up to January 2025) were included. Participants had ≥ 1 CVD risk factor and received community nursing (health education, follow‐up) versus routine care. Random‐effects models in Stata 17.0 analysed outcomes (SBP, DBP, HDL, LDL, TG, smoking). Subgroups assessed sample size, region, duration, and quality. Results Community care significantly reduced SBP (WMD = − 3.54 mmHg, 95% CI: − 4.73 to −2.35; p < 0.001), DBP (WMD = − 1.47 mmHg, −1.94 to −0.99; p < 0.001), LDL ( − 5.11 mg/dL; p < 0.001), and TG ( − 4.21 mg/dL; p = 0.024), with lower smoking persistence (RR = 0.949; p = 0.033). No HDL improvement was observed (WMD = 1.26 mg/dL; p = 0.323). Subgroups showed stronger TG reduction in developing countries (P interaction = 0.010) and greater smoking cessation efficacy in developed nations (P interaction = 0.085). Conclusion Community care effectively lowers blood pressure, LDL, TG, and smoking persistence, supporting its role in primary CVD prevention. Limited HDL impact and regional variations necessitate tailored interventions and further research on HDL functionality.
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