ESCAP: Supervised Exercise for Patients With Coronary Heart Disease in the Primary Care Setting

NCT ID: NCT00146315

Last Updated: 2011-06-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

97 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-01-31

Study Completion Date

2010-06-30

Brief Summary

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In Spain, family physician are currently recommended to prescribe an unsupervised walking program to their coronary heart disease (CHD) patients as a part of their cardiac rehabilitation program. However, there are a few family physicians who provide their CHD patients with supervised exercise (30 minutes of pedaling on an stationary bicycle at 60-85% of the peak heart rate (HR) attained at the maximal or symptom limited treadmill test, 3 times a week) at their primary care health centers, thinking that these patients improve their functional capacity, quality of life, and the control of cardiovascular risk factors, more than walking because they can not achieve the ideal exercise intensity for maximal benefits by walking. This study has been designed to investigate if CHD patients get more health benefits with the supervised exercise program at the health center than with the unsupervised walking program.

Detailed Description

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In order to obtain the maximal health benefits, CHD patients have to attain an exercise intensity between 60 and 85% of the maximal or symptom-limited heart rate (HR). This is not currently attained by the patients who are prescribed an unsupervised walking program.

The OBJECTIVE of this randomized clinical trial is to investigate if CHD patients improve their functional capacity and quality of life more, and control their cardiovascular risk factors better, by coming to their health centers to pedal during 30 minutes on an stationary bicycle , 3 or more times a week, with a HR monitor which makes sure that they attain HRs within the prescribed interval, and supervised by health personal, than by walking without supervision. For that purpose, low risk CHD patients from 11 Spanish health centers will be randomly assigned to a supervised exercise group (ESCAP) or to another unsupervised walking group (control). Both groups will be also provided with health education and the corresponding treatment for cardiovascular risk factor control and complication prevention by their family physicians. The average changes observed in the two groups will be compared, on the basis of intention to treat through analysis of covariance. We will use mixed-effect models to take into account intra-patients and intra-center correlation.

Conditions

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Coronary Heart Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

Secondary prevention program for coronary heart disease

Group Type ACTIVE_COMPARATOR

Secondary prevention program for coronary heart disease

Intervention Type BEHAVIORAL

Secondary prevention program for coronary heart disease

Supervised exercise

Group Type EXPERIMENTAL

Supervised exercise on a stationary bicycle, 3-5 days a week

Intervention Type BEHAVIORAL

Supervised exercise on a stationary bicycle, 3-5 days a week, plus a secondary prevention program for coronary heart disease

Interventions

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Supervised exercise on a stationary bicycle, 3-5 days a week

Supervised exercise on a stationary bicycle, 3-5 days a week, plus a secondary prevention program for coronary heart disease

Intervention Type BEHAVIORAL

Secondary prevention program for coronary heart disease

Secondary prevention program for coronary heart disease

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Coronary heart disease low risk patients
* Under 80 years old

Exclusion Criteria

* 80 years of age and over
* Patients included in cardiac rehabilitation programs
* Moderate and high risk patients
* Patients with handicaps for exercising
* Patients unable to attend the supervised exercise sessions
* Unstable angina
* Uncontrolled atrial ventricular arrhythmias
* Third degree AV block (without pacemaker)
* Uncompensated congestive heart failure
* Severe aortic stenosis
* Suspected or known dissecting aneurysm
* Active myocarditis or pericarditis
* Thrombophlebitis
* Recent embolism
* Acute systemic illness or fever
* Significant emotional distress (psychosis)
* Orthostatic blood pressure drop of \>20 mm Hg with symptoms
* Uncontrolled sinus tachycardia
* Resting ST segment displacement (\>2 mm)
* Uncontrolled diabetes (resting blood glucose \>400 mg/dl)
* Other metabolic problems such as acute thyroiditis, hypo or hyperkalemia, hypovolemia, etc.
* Resting SBP\>200 mm Hg or resting DBP\>110 mm Hg
Minimum Eligible Age

20 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Preventive Services and Health Promotion Research Network

OTHER

Sponsor Role collaborator

Castilla-La Mancha Health Service

OTHER

Sponsor Role collaborator

Castilla-León Health Service

OTHER

Sponsor Role collaborator

Dalt Sant Joan primary care center (Balears Islans Health Service)

UNKNOWN

Sponsor Role collaborator

Public Health Service of Cataluña

OTHER

Sponsor Role collaborator

Public Health Service of Madrid

OTHER

Sponsor Role collaborator

Public Health Service of Galicia

OTHER

Sponsor Role collaborator

Cantabria Health Service

OTHER

Sponsor Role collaborator

Basque Health Service

OTHER_GOV

Sponsor Role lead

Responsible Party

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Castilla La Mancha Health Service

Principal Investigators

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Ricardo Ortega, Dr.

Role: PRINCIPAL_INVESTIGATOR

Santa Barbara primary care center (Castilla La Mancha Health Service)

Locations

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Primary Care Research Unit of Bizkaia (Basque Health Service)

Bilbao, Bizkaia, Spain

Site Status

Santa Barbara primary care center (Castilla La Mancha Health Service)

Toledo, Toledo, Spain

Site Status

Countries

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Spain

References

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Ortega Sanchez-Pinilla R. [Differences in intensity of effort between supervised and non-supervised exercise of patients with ischaemic cardiopathy]. Aten Primaria. 2004 Sep 30;34(5):265-6. doi: 10.1016/s0212-6567(04)70847-1. No abstract available. Spanish.

Reference Type BACKGROUND
PMID: 15456577 (View on PubMed)

Ortega R, Garcia-Ortiz L, Torcal J, Echevarria P, Vargas-Machuca C, Gomez A, Salcedo F, Lekuona I, Montoya I, Grandes G; ESCAP Group. Supervised exercise for acute coronary patients in primary care: a randomized clinical trial. Fam Pract. 2014 Feb;31(1):20-9. doi: 10.1093/fampra/cmt059. Epub 2013 Oct 19.

Reference Type DERIVED
PMID: 24142481 (View on PubMed)

Other Identifiers

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ESCAP-G03/170-200311075

Identifier Type: -

Identifier Source: org_study_id

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