SPRING: Self monitoring and Prevention of
RIsk factors by Nurse practitioners in the region of Groningen. A randomised controlled trial about prevention of cardiovascular disease in general practice.

Cardiovascular diseases are one of the leading causes of death. The aim of the SPRING study is to investigate the effects of lifestyle counselling and medication on patients with a moderately elevated cardiovascular risk (SCORE >/= 5%). The treatment is based on Dutch General Practitioner's Guidelines (which are based on the European guideline that was published in 2003) and is carried out by specially trained nurse practitioners working in general practice. From 20 practices, middle aged men and women, with no history of cardiovascular disease, diabetes or thyroid dysfunction, were invited to establish their risk. People were included if they had a moderately elevated cardiovascular risk (SCORE >/= 5%) and at least one of the following risk factors: smoking, overweight or physical inactivity. Screening started during spring 2008 and finished during spring 2009, from 218 participants informed consent was obtained. The participants were randomly divided into 2 groups and for each participant an individual advice was composed based on the risk profile that was obtained during screening. One group received usual care based on the guidelines, the other group received the same care with additional intensive feedback based on home monitoring from home blood pressure measurement, pedometers etc. After one year follow-up, the effect on the SCORE risk profile and the separate risk factors will be investigated.

We expect that the effect on the cardiovascular risk profile will be higher in people receiving intensive feedback based on home monitoring compared to people receiving usual care.

Baseline and one year follow up: interview (including general characteristics), physical examination, blood tests and standardised questionnaires (as mentioned above).

All participants had a moderately elevated cardiovascular risk profile (SCORE >/= 5%) and received 1 year of life style counseling and medication according to Dutch General Practitioner's Guidelines (which are based on the European guideline that was published in 2003), by specially trained nurse practitioners. One group received usual care based on these guidelines, the other group received the same care with additional intensive feedback based on home monitoring from home blood pressure measurement, pedometers etc.