Skin autofluorescence as proxy of tissue AGE accumulation is dissociated from SCORE cardiovascular risk score, and remains so after 3 years.

Background: Skin autofluorescence (SAF), as a proxy of AGE accumulation, is predictive of cardiovascular (CVD) complications in i.a. type 2 diabetes mellitus and renal failure, independently of most conventional CVD risk factors.

Maintenance of lifestyle changes: 3-year results of the Groningen Overweight and Lifestyle study.

Objective: This study aims to evaluate the three-year effect of lifestyle counseling by a nurse practitioner (NP) on physical activity (PA) and dietary intake compared with usual care by a general practitioner (GP).

Methods: At baseline, subjects were randomly allocated to the NP group (n = 225) or to the GP group (n = 232). The NP group received a low-intensive lifestyle intervention for three years by the NP and the GP group received one consultation by the GP and thereafter usual care.

Process evaluation of a lifestyle intervention in primary care: implementation issues and the participants' satisfaction of the GOAL study.

The Groningen Overweight and Lifestyle (GOAL) intervention effectively prevents weight gain. The present study describes a process evaluation in which 214 participants in the intervention group received a structured questionnaire within 7 months (a median of 5 months) after the end of the intervention. The authors investigated the content of the intervention (on basis of the participants' recall), the participants' satisfaction of the intervention, the participants' satisfaction with the nurse practitioners (NPs), and the determinants of the participants' satisfaction.

Preventing weight gain by lifestyle intervention in a general practice setting: three-year results of a randomized controlled trial.

Background: Weight regain after initial loss of weight is common, which indicates a need for lifestyle counseling aimed at preventing weight gain instead of weight loss. This study was conducted to determine whether structured lifestyle counseling by nurse practitioners (NPs) group compared with usual care by general practitioners (GP-UC) in overweight and obese patients can prevent (further) weight gain.

Methods: A randomized controlled trial in 11 general practice locations in the Netherlands of 457 patients (body mass index, 25-40 [calculated as weight in kilograms divided by height in meters squared]; mean age, 56 years; 52% female) with either hypertension or dyslipidemia or both.

Changes in lifestyle habits after counselling by nurse practitioners: 1-year results of the Groningen Overweight and Lifestyle study.

Objectives: The Groningen Overweight and Lifestyle (GOAL) study primarily aims at preventing weight gain by nurse practitioners (NP) guided by a standardized computerized software program. Since favourable changes in physical activity (PA) and diet may improve health independently of weight (loss), insight into effects on lifestyle habits is essential. We examined the 1-year effects of lifestyle counselling by NP on PA and diet, compared with usual care from the general practitioner (GP-UC).

Structured primary care for type 2 diabetes has positive effects on clinical outcomes.

Background: Patients with type 2 diabetes have an increased risk of developing microvascular and macrovascular complications. In routine diabetes care an adequate reduction of risk factors for these complications is often not achieved.

Objective: The aim of the study was to evaluate the effects of structured diabetes care on clinical outcomes of patients with type 2 diabetes in primary care.

Preventing weight gain: one-year results of a randomized lifestyle intervention.

Background: Lifestyle interventions targeting prevention of weight gain may have better long-term success than when aimed at weight loss. Limited evidence exists about such an approach in the primary care setting.

Design: An RTC was conducted.

Self-measurement of blood pressure at home reduces the need for antihypertensive drugs: a randomized, controlled trial.

It is still uncertain whether one can safely base treatment decisions on self-measurement of blood pressure. In the present study, we investigated whether antihypertensive treatment based on self-measurement of blood pressure leads to the use of less medication without the loss of blood pressure control. We randomly assigned 430 hypertensive patients to receive treatment either on the basis of self-measured pressures (n=216) or office pressures (OPs; n=214).

Determinants for the adoption of angiotensin II receptor blockers by general practitioners.

Results of studies conducted 10-20 years ago show the prominence of commercial information sources in the adoption process of new drugs. Over the past decade, there has been a growing emphasis on practicing evidence-based medicine in drug prescribing. This raises the question whether professional information sources currently counterbalance the influence of commercial information sources in the adoption process.

Uptake of angiotensin II receptor blockers in the treatment of hypertension.

Objective: To examine trends in prescribing of angiotensin II receptor blockers (ARBs) as initial and second-line treatment of hypertension.

Methods: We performed a cohort study in the Integrated Primary Care Information database, a general practice research database in The Netherlands. We included hypertensive patients who were newly treated with antihypertensive drugs between 1996 and 1999.

Does comorbidity explain trends in prescribing of newer antihypertensive agents?

Objective: Concerns exist about heavily prescribing of new drugs when the evidence on hard outcomes is still limited. This has been the case for the newer classes of antihypertensives, especially in hypertensive patients without additional comorbidity. The association between comorbidity and trends in prescribing of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARBs) was examined for the period 1996-2000.