Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Mats Börjesson, University of Gothenburg,
- Second opponent: Associate Professor Inger-Lise Aamot Aksetøy, St.Olavs University Hospital,
- Third member and chair of the evaluation committee: Professor Per Ole Iversen, University of Oslo
Chair of the Defence
Professor Arnljot Tveit, University of Oslo
Principal Supervisor
Head Senior Consultant Tor Ole Klemsdal, OUS - Oslo University Hospital
Summary
Cardiovascular diseases remain a leading cause of premature morbidity and mortality. Despite strong evidence relating modifiable risk factors to cardiovascular disease, and preventive guidelines emphasizing lifestyle intervention, risk factor control remains suboptimal and long-term effects are insufficiently documented.
The meta-analysis included as the first paper in this thesis concluded that lifestyle interventions have limited impact on major cardiovascular risk factors after 24 months, though a modest reduction in systolic blood pressure may be clinically relevant.
The main aim of the thesis was to evaluate the efficacy of a newly developed multifactorial lifestyle intervention in individuals at elevated risk. The programme was based on existing structures in Norwegian health care, combining a hospital course with follow-up through primary care and local resources. Efficacy was assessed in a randomized controlled trial with 601 participants completing 36 months follow-up, using four global risk scores (NORRISK, Framingham, PROCAM, NORRISK 2) and selected risk factors.
All four scores improved significantly in the intervention group, corresponding to ~20% relative risk reduction. Smoking and metabolic syndrome prevalence declined significantly more in the intervention group vs controls. No significant differences were found for blood pressure or lipids, though LDL and triglyceride changes were borderline significant. Physical activity increased significantly more in the intervention group. Psychological well-being improved in both groups, with a greater increase in the intervention group. Medication use was high, but participation reduced the need for new prescriptions. No effects were observed on markers of inflammation or glucose metabolism.
These results are promising for addressing the need for effective preventive interventions, which aligns with a key health policy objective in Norway, and should encourage further efforts to improve preventive programs.
Additional information
Contact the research support staff.