Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Ann-Dorthe Zwisler, REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care and Holbæk Hospital, Denmark
- Second opponent: Senior Consultant Jostein Grimsmo, LHL, the National Association for Heart and Lung Diseases
- Third member and chair of the evaluation committee: Professor Emeritus Harald Arnesen, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor Ingrid Os, Faculty of Medicine, University of Oslo
Principal Supervisor
Senior Consultant Jan Erik Otterstad, Vestfold Hospital Trust
Summary
Risk factor control is essential for the prognosis after coronary events. European studies have revealed poor risk factor control in secondary prevention.
The aim of this thesis was to determine risk factor control after coronary events, to study the role of cardiac rehabilitation (CR) for risk factor control, as well as to identify medical and psychosocial factors associated with low physical activity (PA). Data from hospital records, clinical examinations, blood samples and questionnaires were used.
This cross-sectional study of 1127 patients with stable coronary heart disease from routine clinical practice in two Norwegian hospitals (Vestfold and Drammen) demonstrated that risk factor control in patients was poor after a mean of 17 months after a coronary event.
In Vestfold 75 % and in Drammen 18 % participated in CR, with large differences in the composition and extent of the CR programs. CR participants in Vestfold had better coronary risk factor control compared to non-CR, although not good enough.
In all, 18% of the patients were inactive and only 40% adequately active. Insufficient PA was associated with smoking, obesity, unfavourable diet, depression and poor quality of life. High motivation and better illness perception were associated with self-reported increase in PA.
The reproducibility of the questionnaire used was found to be highly acceptable.
Our finding of suboptimal secondary prevention in Norway emphasises the need for better management of the established risk factors in clinical practice. Thus, interventions to increase the participation rate and quality of CR seem essential. There is also a need for further research on the effect of more comprehensive CR programmes with interventions that to a greater extent are tailored to each risk factor and patient factors like depression, motivation, illness and risk perception.
Additional information
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